| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFITS INT'L ARIZONA INC3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $117K | $0 | $117K | 14.64% |
| EMPLOYEE BENEFITS INT'L ARIZONA INC3 | 2525 EAST ARIZONA BILTMORE CIRCLE SUITE D1 PHOENIX, AZ 85016 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $21K | $21K | 2.68% |
| FMLASOURCE INC5 Filed as: FMLASOURCE, INC. | 455 NORTH CITYFRONT PLAZA DRIVE CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $19K | $19K | 2.42% |
| EMPLOYEE BENEFITS INT'L ARIZONA INC3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | DELTA DENTAL OF ARIZONA | $10K | $0 | $10K | 9.89% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE, SUITE 200 ST. PETERSBURG, FL 33702 | METLIFE LEGAL PLANS, INC. | $9K | $0 | $9K | 21.90% |
| EMPLOYEE BENEFITS INT'L ARIZONA INC3 | 8828 NORTH CENTRAL AVENUE SUITE 100 PHOENIX, AZ 85020 | METLIFE LEGAL PLANS, INC. | $4K | $0 | $4K | 10.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMIN., INC. | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS, INC. | $0 | $2K | $2K | 5.08% |
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 | 1,532 | 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) | 1,532 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | DELTA DENTAL OF ARIZONA | 1,286 | $99K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,536 | $798K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,536 | $798K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,536 | $798K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,536 | $837K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,536 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.