| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: SOUTHWEST RISK MANAGEMENT LLC | 4801 E MCKELLIPS RD MESA, AZ 852152527 | PRINCIPAL LIFE INSURANCE COMPANY | $18K | — | $18K | 11.71% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $3K | $78 | $3K | 12.34% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $503 | $20 | $523 | 2.31% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST STREET TULSA, OK 74137 | AFLAC | $362 | — | $362 | 1.60% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $353 | — | $353 | 1.56% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $328 | $20 | $348 | 1.54% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $289 | $27 | $316 | 1.40% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $113 | — | $113 | 0.50% |
| CARLOS CHAVEZ3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $74 | — | $74 | 0.33% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $65 | — | $65 | 0.29% |
| KAYELA MAJOROS3 | 11273 W ROCK ART DR MARANA, AZ 85658 | AFLAC | $58 | — | $58 | 0.26% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $58 | — | $58 | 0.26% |
| NICHOLAS CAFFREY3 | 6502 N CALLE LOTTIE TUCSON, AZ 85718 | AFLAC | $26 | — | $26 | 0.12% |
| LYNN MENDOZA3 | 1368 W 13TH ST YUMA, AZ 85364 | AFLAC | $25 | — | $25 | 0.11% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $1K | $22 | $1K | 6.25% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST STREET TULSA, OK 74137 | AFLAC | $457 | — | $457 | 2.76% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $157 | $32 | $189 | 1.14% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $133 | — | $133 | 0.80% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $125 | — | $125 | 0.76% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $57 | $4 | $61 | 0.37% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $54 | $3 | $57 | 0.34% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $39 | — | $39 | 0.24% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $36 | — | $36 | 0.22% |
| LYNN MENDOZA3 | 1368 W 13TH ST YUMA, AZ 85364 | AFLAC | $10 | — | $10 | 0.06% |
| KAYELA MAJOROS3 | 11273 W ROCK ART DR MARANA, AZ 85658 | AFLAC | $7 | — | $7 | 0.04% |
| NODOR INC3 | 955 N ST FRESNO, CA 93721 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 25.00% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $597 | — | $597 | 15.58% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $122 | — | $122 | 3.18% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $79 | — | $79 | 2.06% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST STREET TULSA, OK 74137 | AFLAC | $52 | — | $52 | 1.36% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $33 | — | $33 | 0.86% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $17 | — | $17 | 0.44% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $15 | — | $15 | 0.39% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $6 | — | $6 | 0.16% |
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 | 233 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 313 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 478 | $153K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 478 | $153K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 478 | $160K |
| Other(4 contracts, 2 carriers) | AFLAC | 232 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 478 | — |
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.