| 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 | $19K | — | $19K | 13.25% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $6K | $72 | $6K | 15.28% |
| TULA BOYLES3 | 12495 W GINI LN MARANA, AZ 85653 | AFLAC | $4K | — | $4K | 8.88% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $1K | $57 | $1K | 2.55% |
| NICHOLAS J DONIA3 Filed as: NICHOLAS DONIA | 843 W CALLE MURO FUERTE SAHUARITA, AZ 85629 | AFLAC | $1K | — | $1K | 2.54% |
| JACKIE G BARTA3 Filed as: JACKIE BARTA | 3500 N MALLARD CIR SIERRA VISTA, AZ 85635 | AFLAC | $677 | — | $677 | 1.62% |
| CARLOS CHAVEZ3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $374 | $9 | $383 | 0.91% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST ST TULSA, OK 74137 | AFLAC | $303 | — | $303 | 0.72% |
| KAYELA FORD3 | 976 YESTERDAY LN MEDINA, OH 44256 | AFLAC | $244 | $15 | $259 | 0.62% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $170 | $13 | $183 | 0.44% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $93 | $13 | $106 | 0.25% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $94 | — | $94 | 0.22% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $80 | — | $80 | 0.19% |
| NICHOLAS CAFFREY3 | 6502 N CALLE LOTTIE TUCSON, AZ 85718 | AFLAC | $64 | $7 | $71 | 0.17% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $47 | — | $47 | 0.11% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $43 | — | $43 | 0.10% |
| ELIAN MEZA3 | 1017 E WEST CIRCLE DR TUCSON, AZ 85719 | AFLAC | $19 | — | $19 | 0.05% |
| DAMARIS MORENO3 | 3902 S 15TH AVE TUCSON, AZ 85714 | AFLAC | $19 | — | $19 | 0.05% |
| LYNN MENDOZA3 | 1368 W 13TH ST YUMA, AZ 85364 | AFLAC | $17 | — | $17 | 0.04% |
| TULA BOYLES3 | 12495 W GINI LN MARANA, AZ 85653 | AFLAC | $2K | — | $2K | 8.68% |
| KELLY MCGARRY3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $2K | $12 | $2K | 8.54% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $655 | — | $655 | 2.64% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST ST TULSA, OK 74137 | AFLAC | $377 | — | $377 | 1.52% |
| NICHOLAS J DONIA3 Filed as: NICHOLAS DONIA | 843 W CALLE MURO FUERTE SAHUARITA, AZ 85629 | AFLAC | $343 | — | $343 | 1.38% |
| JACKIE G BARTA3 Filed as: JACKIE BARTA | 3500 N MALLARD CIR SIERRA VISTA, AZ 85635 | AFLAC | $291 | — | $291 | 1.17% |
| CARLOS CHAVEZ3 | 4750 N ORACLE RD STE 214 TUCSON, AZ 85705 | AFLAC | $191 | — | $191 | 0.77% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $114 | — | $114 | 0.46% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $107 | — | $107 | 0.43% |
| KAYELA FORD3 | 976 YESTERDAY LN MEDINA, OH 44256 | AFLAC | $99 | $3 | $102 | 0.41% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $85 | — | $85 | 0.34% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $41 | — | $41 | 0.17% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $17 | — | $17 | 0.07% |
| LYNN MENDOZA3 | 1368 W 13TH ST YUMA, AZ 85364 | AFLAC | $17 | — | $17 | 0.07% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $14 | — | $14 | 0.06% |
| NODOR INC3 | 955 N ST FRESNO, CA 93721 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 25.03% |
| JARCEY RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $358 | $56 | $414 | 11.42% |
| ROXANNE WISWOSSER3 | 1004 GEORGIA ST TEHACHAPI, CA 93561 | AFLAC | $82 | $13 | $95 | 2.62% |
| ROCHELLE MAURER3 | 1143 BLACK OAK DR TEHACHAPI, CA 93561 | AFLAC | $49 | $13 | $62 | 1.71% |
| RICK M MCKINNEY3 Filed as: RICK MCKINNEY | 2448 E 81ST ST TULSA, OK 74137 | AFLAC | $45 | — | $45 | 1.24% |
| KASIE L RODRIGUEZ3 Filed as: KASIE RODRIGUEZ | 4054 S CEDAR AVE YUMA, AZ 85365 | AFLAC | $20 | — | $20 | 0.55% |
| ZAKERY HARLOW3 | 2030 W BASELINE RD STE 182-17062 PHOENIX, AZ 85041 | AFLAC | $14 | — | $14 | 0.39% |
| SETH G KNOWLTON3 Filed as: SETH KNOWLTON | 11396 N SILVER PHEASANT LOOP ORO VALLEY, AZ 85737 | AFLAC | $13 | — | $13 | 0.36% |
| FILIPE COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $6 | — | $6 | 0.17% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 452 | $141K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 452 | $141K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 452 | $148K |
| Other(4 contracts, 2 carriers) | AFLAC | 221 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 452 | — |
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.