| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WESTERN GROWERS INSURANCE SERVICES3 | 15525 SAND CANYON AVE IRVINE, CA 926183114 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.61% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT | ADMINISTRATION 721 S PARKER ST STE 300 ORANGE, CA 928684732 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.35% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $8K | — | $8K | 21.93% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 4960 MOLLY POND CT COLORADO SPRINGS, CO 80917 | AFLAC | $8K | — | $8K | 21.84% |
| ZAKERY HARLOW3 | 3204 N ACADEMY BLVD STE 130 COLORADO SPRINGS, CO 80917 | AFLAC | $2K | — | $2K | 5.10% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $124 | — | $124 | 0.36% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $6K | — | $6K | 21.60% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 4960 MOLLY POND CT COLORADO SPRINGS, CO 80917 | AFLAC | $5K | — | $5K | 21.48% |
| ZAKERY HARLOW3 | 3204 N ACADEMY BLVD STE 130 COLORADO SPRINGS, CO 80917 | AFLAC | $1K | — | $1K | 4.89% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $185 | — | $185 | 0.72% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 53 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $46K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $46K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $46K |
| Other(2 contracts) | AFLAC | 69 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.