| 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 | $3K | $8K | 1.93% |
| 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 | $42K | $10K | $52K | 18.59% |
| 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 | $21K | $5K | $25K | 18.32% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $5K | $18K | 13.47% |
| JENNIFER O'ROURKE3 | 9225 E TANQUE VERDE RD SUITE 9103 TUCSON, AZ 85749 | AFLAC | $9K | $236 | $9K | 10.16% |
| KAYELA MAJOROS3 Filed as: KAYELA MAJOROS (FORD) | 11273 W ROCK ART DR MARANA, AZ 85658 | AFLAC | $2K | $37 | $2K | 1.85% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $1K | $55 | $1K | 1.53% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $949 | — | $949 | 1.02% |
| KAMIL A BREEDLOVE3 Filed as: KAMIL BREEDLOVE | 4700 N 16 ST APT 343 PHOENIX, AZ 85016 | AFLAC | $434 | $18 | $452 | 0.49% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $452 | — | $452 | 0.49% |
| KEVIN DALE HARLOW3 Filed as: KEVIN HARLOW | 2960 N ACADEMY BLVD. COLORADO SPRINGS, CO 80917 | AFLAC | $395 | — | $395 | 0.42% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD SUITE 182-17062 PHOENIX, AZ 85041 | AFLAC | $378 | — | $378 | 0.41% |
| JANELL FRANK3 | 2005 WAVE DRIVE STAFFORD, VA 22554 | AFLAC | $337 | — | $337 | 0.36% |
| H LARAINE OLIPHANT3 | 3580 W INA RD SUITE 150 TUCSON, AZ 85741 | AFLAC | $308 | — | $308 | 0.33% |
| KIMBERLY J RODRIGUEZ3 | 37057 S GAMBEL QUAIL DR MARANA, AZ 85658 | AFLAC | $244 | — | $244 | 0.26% |
| CATHERINE DAVIS3 | 9160 E LOMA LINDA PLACE TUCSON, AZ 85749 | AFLAC | $176 | — | $176 | 0.19% |
| NICOLE VAN WINDEN3 | 411 S ESSEX LN TUCSON, AZ 85711 | AFLAC | $134 | — | $134 | 0.14% |
| KAITLIN RENE CZARNECKI3 | 15385 E CAMINO DOROTEA VAIL, AZ 85641 | AFLAC | $130 | — | $130 | 0.14% |
| DAVID R LATTIMER3 | 6605 N 93RD AVE GLENDALE, AZ 85305 | AFLAC | $113 | — | $113 | 0.12% |
| SANDRA L SARFF3 | 3811 E CHICO LN TUCSON, AZ 85739 | AFLAC | $49 | — | $49 | 0.05% |
| ERIC PEDERSON3 | 1527 HUCKLEBERRY SPRINGS RD KNOXVILLE, TN 37914 | AFLAC | $41 | — | $41 | 0.04% |
| SCOTT WEBB3 | 26729 N 91ST DR PEORIA, AZ 85383 | AFLAC | $37 | — | $37 | 0.04% |
| MARK HILL3 | 5188 E PARK VISTA DR TUCSON, AZ 85756 | AFLAC | $36 | — | $36 | 0.04% |
| CHAD P SCHNEIDER3 | 22213 1/2 ERWIN ST UNIT 303 WOODLAND HILLS, CA 91367 | AFLAC | $29 | — | $29 | 0.03% |
| DONALD GREEN3 | 4719 S HARVEST MOON DR GREEN VALLEY, AZ 85622 | AFLAC | $28 | — | $28 | 0.03% |
| BRYAN G CORBIN LLC3 Filed as: BRYAN CORBIN LLC | 6950 SW HAMPTON ST SUITE 260 TIGARD, OR 97223 | AFLAC | $25 | — | $25 | 0.03% |
| NICHOLAS CAFFREY3 | 6502 N CALLE LOTTIE TUCSON, AZ 85718 | AFLAC | $24 | — | $24 | 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% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 45263 | AFLAC | $14 | — | $14 | 0.02% |
| LAUREL L HARLOW3 | 2030 E BASELINE RD STE 182 PHOENIX, AZ 85041 | AFLAC | $12 | — | $12 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | PO BOX 32702 TUCSON, AZ 85751 | AFLAC | $10 | — | $10 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | PO BOX 730054 DALLAS, TX 75373 | AFLAC | $9 | — | $9 | 0.01% |
| BRENDA S O BERRY3 | PO BOX 686 THATCHER, AZ 85552 | AFLAC | $8 | — | $8 | 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% |
| JACOB C ECHOLS3 | 15824 E PARK AVE GILBERT, AZ 85234 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL G GLADNICK3 Filed as: MICHAEL GLADNICK | 3850 E BASELINE RD SUITE 116 MESA, AZ 85206 | AFLAC | $4 | — | $4 | 0.00% |
| NATALIE MALHAM3 | 5822 N 13TH ST PHOENIX, AZ 85014 | AFLAC | $4 | — | $4 | 0.00% |
| PREFERRED MARKETING CORP3 | 817 CYPRESS OAK CIR DELAND, AZ 32720 | AFLAC | $4 | — | $4 | 0.00% |
| MARIA MULLIGAN3 | 2330 SNEAD DR OCEANSIDE, AZ 92056 | AFLAC | $3 | — | $3 | 0.00% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT GUTHRIE | 436 LONE STAR LN HIDEAWAY, TX 75771 | AFLAC | $3 | — | $3 | 0.00% |
| SHARON MCKELVEY3 | 589 E CONESTOGA CIR GRAND JUNCTION, CO 81504 | 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% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OK 452632886 | VISION SERVICE PLAN | $1K | — | $1K | 1.70% |
| 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 | $1K | $5K | 13.52% |
| 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 | — | $253K |
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 | 724 | 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) | 724 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 1,306 | $430K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 1,306 | $495K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 724 | $173K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 224 | $370K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 724 | $137K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 724 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,306 | — |
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.