| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $11K | — | $11K | 9.87% |
| SALLY COKER3 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | ANTHEM LIFE INSURANCE COMPANY AND STANDARD INSURANCE COMPANY | $7K | — | $7K | 10.57% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | EYEMED VISION CARE | $3K | — | $3K | 9.95% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 14.47% |
| SALLY COKER3 | 38275 N. 103RD PLACE SCOTTSDALE, AZ 85262 | CIGNA DENTAL HEALTH OF CALIFORNIA INC. | $586 | — | $586 | 9.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON INSURANCE SERVICES LLC | PO BOX 6030 PASADENA, CA 91102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $634 | — | $634 | 13.50% |
| MCCAREY INC3 | 6320 GREENHAVEN DR CARLSBAD, CA 92009 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | — | $127 | 2.70% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LN PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 1.06% |
| EDWIN MANUEL VELASQUEZ3 | 33013 SEVILLE ST LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.92% |
| BRIAN COHEN3 | 6804 N CPTL TX HWY APT 221 AUSTIN, TX 78731 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.64% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.53% |
| DONALD C SAVOY INC3 Filed as: DONALD TERRY GOTHAM | 3129 ECLIPSE DR GREEN BAY, WI 54311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH AN AETNA COMPANY EIN 16-1264154 TPA TO THE EMPLOYER | Claims processing Service code 12 | — | $169K |
| SALLY COKER HEALTH BROKER CONSULTANT | Insurance agents and brokers Service code 22 | 38275 N 103RD PLACE SCOTTSDALE, AZ 85262 | $90K |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 194 | $117K |
| Vision | EYEMED VISION CARE | 203 | $25K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY AND STANDARD INSURANCE COMPANY | 447 | $68K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 26 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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.