| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | AMERITAS LIFE INSURANCE CORP. | $5K | $5K | $9K | 2.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $37K | — | $37K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $9K | $9K | 3.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | — | $12K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 3.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | — | $17K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 4.48% |
| JENNIFER O'ROURKE3 | 9225 E TANQUE VERDE RD SUITE 9103 TUCSON, AZ 85749 | AFLAC | $10K | $138 | $11K | 11.54% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $1K | $32 | $1K | 1.56% |
| KAMIL A BREEDLOVE3 Filed as: KAMIL BREEDLOVE | 4700 N 16 ST APT 238 PHOENIX, AZ 85016 | AFLAC | $1K | $32 | $1K | 1.47% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $1K | — | $1K | 1.20% |
| KAYELA MAJOROS3 | 11273 W ROCK ART DR MARANA, AZ 85658 | AFLAC | $545 | — | $545 | 0.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $509 | — | $509 | 0.56% |
| KEVIN DALE HARLOW3 Filed as: KEVIN HARLOW | 2960 N ACADEMY BLVD. COLORADO SPRINGS, CO 80917 | AFLAC | $449 | — | $449 | 0.49% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD SUITE 182-17062 PHOENIX, AZ 85041 | AFLAC | $423 | — | $423 | 0.46% |
| JANELL FRANK3 | 2005 WAVE DRIVE STAFFORD, VA 22554 | AFLAC | $371 | — | $371 | 0.41% |
| H LARAINE OLIPHANT3 | 3580 W INA RD SUITE 150 TUCSON, AZ 85741 | AFLAC | $308 | — | $308 | 0.34% |
| KIMBERLY J RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $274 | — | $274 | 0.30% |
| CATHERINE DAVIS3 | 9160 E LOMA LINDA PLACE TUCSON, AZ 85749 | AFLAC | $181 | — | $181 | 0.20% |
| DAVID R LATTIMER3 | 6605 N 93RD AVE GLENDALE, AZ 85305 | AFLAC | $145 | — | $145 | 0.16% |
| SANDRA L SARFF3 | 3811 E CHICO LN TUCSON, AZ 85739 | AFLAC | $49 | — | $49 | 0.05% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $42 | — | $42 | 0.05% |
| ERIC PEDERSON3 | 1527 HUCKLEBERRY SPRINGS RD KNOXVILLE, TN 37914 | AFLAC | $41 | — | $41 | 0.04% |
| MARK HILL3 | 5188 E PARK VISTA DR TUCSON, AZ 85756 | AFLAC | $36 | — | $36 | 0.04% |
| BRYAN G CORBIN LLC3 Filed as: BRYAN CORBIN LLC | 6950 SW HAMPTON ST SUITE 260 TIGARD, OR 97223 | AFLAC | $30 | — | $30 | 0.03% |
| CHAD P SCHNEIDER3 | 4470 WOODMAN AVE UNIT 303 SHERMAN OAKS, CA 91423 | AFLAC | $29 | — | $29 | 0.03% |
| DONALD GREEN3 | 1611 W PACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $28 | — | $28 | 0.03% |
| LAUREL L HARLOW3 | 2030 E BASELINE RD STE 182 PHOENIX, AZ 85041 | AFLAC | $26 | — | $26 | 0.03% |
| JERRY DUNCAN3 Filed as: JERRY F. HOKE | 517 E 3270 N LEHI, UT 84043 | AFLAC | $19 | — | $19 | 0.02% |
| JULIE KICKER3 Filed as: JULIE A KICKER | PO BOX 11825 CASA GRANDE, AZ 85130 | AFLAC | $18 | — | $18 | 0.02% |
| CHEYANNA SARFF3 | 3737 W CROMWELL DR TUCSON, AZ 85741 | AFLAC | $17 | — | $17 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 32702 TUCSON, AZ 85751 | AFLAC | $15 | — | $15 | 0.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $14 | — | $14 | 0.02% |
| TREVOR BRYAN DAVIS3 | 9160 E LOMA LINDA PL TUCSON, AZ 85749 | AFLAC | $12 | — | $12 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | PO BOX 789054 DALLAS, TX 75373 | AFLAC | $9 | — | $9 | 0.01% |
| BRENDA S O BERRY3 | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $8 | — | $8 | 0.01% |
| JACOB C ECHOLS3 | 3850 E BASELINE RD SUITE 600 MESA, AZ 85206 | AFLAC | $7 | — | $7 | 0.01% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 33202 N 46TH WAY CAVE CREEK, AZ 85331 | AFLAC | $6 | — | $6 | 0.01% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $5 | — | $5 | 0.01% |
| NATALIE MALHAM3 | 5822 N 13TH ST PHOENIX, AZ 85014 | AFLAC | $5 | — | $5 | 0.01% |
| PREFERRED MARKETING CORP3 | 744 E DENIM TRL SAN TAN VALLEY, AZ 85143 | AFLAC | $4 | — | $4 | 0.00% |
| MARIA MULLIGAN3 | 15131 W DYNAMITE BLVD SUN CITY WEST, AZ 85387 | AFLAC | $3 | — | $3 | 0.00% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT GUTHRIE | 14227 N 14TH ST PHOENIX, AZ 85022 | AFLAC | $3 | — | $3 | 0.00% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LANE LOT 3 PAYSON, AZ 85541 | AFLAC | $2 | — | $2 | 0.00% |
| JEFFREY S GIBSON3 Filed as: JEFFREY GIBSON | 4030 TATES CREEK ROAD APT 1004 CONSHOHOCKEN, PA 40517 | AFLAC | $2 | — | $2 | 0.00% |
| MICHAEL G RYAN3 Filed as: MICHAEL RYAN | PO BOX 60 CHROMO, CO 81128 | AFLAC | $2 | — | $2 | 0.00% |
| RAYMOND MULLIGAN3 | 8765 W KELTON LN BLDG B1 PEORIA, AZ 85382 | AFLAC | $2 | — | $2 | 0.00% |
| JULIA ANN COAST3 Filed as: JULIA COAST | 1409 E MALIBU DR TEMPE, AZ 85282 | AFLAC | $1 | — | $1 | 0.00% |
| TIMOTHY MARTIN3 | 20516 N 80TH LN PEORIA, AZ 85382 | AFLAC | $1 | — | $1 | 0.00% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR TUCSON, AZ 85310 | AFLAC | $0 | — | $0 | 0.00% |
| LINDA J DOSS3 Filed as: LINDA DOSS | 6556 S VAN BUREN AVE TUCSON, AZ 85756 | AFLAC | $0 | — | $0 | 0.00% |
| BARBARA ANN MCNAUGHTON3 | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $0 | — | $0 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OK 452632886 | VISION SERVICE PLAN | $1K | — | $1K | 1.86% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | P.O. BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICES | $1K | — | $1K | 7.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $174K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 678 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 678 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 541 | $341K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 551 | $396K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 678 | $142K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $335K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 678 | $116K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 678 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 678 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.