| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SVCS WEST INC | 75 REMITTANCE DRIVE STE 1446 CHICAGO, IL 60675 | BLUE CROSS BLUE SHIELD OF ARIZONA | $217K | — | $217K | 4.51% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SVCS WEST INC | PO BOX 19640 IRVINE, CA 926239640 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $3K | $19K | 5.17% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SERVICES | KURSTIN BARTHOLOMEW 1005 CONVENTION PLAZA ST. LOUIS, MO 63101 | DELTA DENTAL OF ARIZONA | $28K | — | $28K | 8.83% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | PO BOX 6718 SOMMERSET, NJ 088756718 | METROPOLITAN LIFE INSURANCE COMPANY | — | $184 | $184 | 0.91% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | PO BOX 6718 SOMMERSET, NJ 088756718 | METROPOLITAN LIFE INSURANCE COMPANY | — | $156 | $156 | 0.89% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | PO BOX 6718 SOMMERSET, NJ 088756718 | METROPOLITAN LIFE INSURANCE COMPANY | — | $156 | $156 | 0.94% |
No Schedule C service providers reported on this filing.
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 | 411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 418 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 837 | $4.9M |
| Dental | DELTA DENTAL OF ARIZONA | 701 | $316K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 621 | $54K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $367K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $367K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $367K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 837 | $4.8M |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $384K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 837 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.