| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| APRIL L FARRELL3 | 4809 WEST TULSA STREET CHANDLER, AZ 85226 | AFLAC | $2K | $153 | $2K | 8.40% |
| DENISE JANE FORCONI3 | 30411 NORTH 72ND PLACE SCOTTSDALE, AZ 85266 | AFLAC | $367 | $31 | $398 | 1.46% |
| MICHAEL BACKHOFF3 | 906 BRADFORD AVENUE NASHVILLE, TN 37204 | AFLAC | $338 | — | $338 | 1.24% |
| MARK METTILLE3 Filed as: MARK WHEELER | 5344 EAST ACOMA DRIVE SCOTTSDALE, AZ 85254 | AFLAC | $256 | — | $256 | 0.94% |
| MARVIN LEE WILKERSON3 | 884 HOLLY TREE GAP ROAD BRENTWOOD, TN 37027 | AFLAC | $196 | — | $196 | 0.72% |
| JEFFERY S GIBSON3 | 4805 LAKE BROOK DRIVE SUITE 220 GLEN ALLEN, VA 23060 | AFLAC | $124 | $31 | $155 | 0.57% |
| M JEAN HEMP3 | P.O. BOX 41292 MESA, AZ 85274 | AFLAC | $126 | — | $126 | 0.46% |
| PATRICIA J GEE3 | P.O. BOX 2334 MESA, AZ 85214 | AFLAC | $120 | — | $120 | 0.44% |
| MERLE DALE HALL3 | 5500 WEST LAKE RIVER LANE BOISE, ID 83703 | AFLAC | $63 | — | $63 | 0.23% |
| BRITTON JOHNSON3 Filed as: BRITTON L JOHNSON | 1701 CENTERVIEW DRIVE SUITE 300 LITTLE ROCK, AR 72211 | AFLAC | $59 | — | $59 | 0.22% |
| GREGORY F STENZEL3 | 1249 KIOWA DRIVE WEST GAINESVILLE, TX 76240 | AFLAC | $44 | — | $44 | 0.16% |
| KATHY LEE BRIGHT3 | 788 EAST PEPPER DRIVE CASA GRANDE, AZ 85122 | AFLAC | $43 | — | $43 | 0.16% |
| BRITTON JOHNSON3 Filed as: BRITTON L JOHNSON | 8 SHACKLEFORD PLAZA SUITE 300 LITTLE ROCK, AR 72211 | AFLAC | $40 | — | $40 | 0.15% |
| GARY A YARBROUGH3 Filed as: GARY Y YARBROUGH | 1436 NORTH HIGHLEY ROAD SUITE 100 GILBERT, AZ 85234 | AFLAC | $38 | — | $38 | 0.14% |
| NICHOLAS E VIGIL3 | 120 ROCKBOLT CIRCLE FOLSOM, CA 95630 | AFLAC | $38 | — | $38 | 0.14% |
| PREFERRED MARKETING CORP3 Filed as: PREFERRED MARKETING CORPORATION | 1194 EAST LAKEVIEW DRIVE SUN TAN VALLEY, AZ 85143 | AFLAC | $27 | — | $27 | 0.10% |
| SCOTT WEBB3 | 12366 WEST MILTON DRIVE PEORIA, AZ 85383 | AFLAC | $26 | — | $26 | 0.10% |
| ORIN LEE WILLIAMS3 | 313 NORTH CORRINE DRIVE GILBERT, AZ 85234 | AFLAC | $26 | — | $26 | 0.10% |
| GLEN DOUGLAS GABLE3 | 3521 SOUTH CAMELLIA PLACE CHANDLER, AZ 85248 | AFLAC | $21 | — | $21 | 0.08% |
| SCOTT WEBB3 | 2155 WEST PINNACLE PEAK ROAD SUITE 205 PHOENIX, AZ 85027 | AFLAC | $17 | — | $17 | 0.06% |
| SUSAN KELLI RICHARDSON3 | 14938 WEST MAUNA LOA LANE SURPRISE, AZ 85379 | AFLAC | $16 | — | $16 | 0.06% |
| WILLIAM H LENBERG3 | 10920 FAROLA DRIVE NW ALBUQUERQUE, NM 87114 | AFLAC | $14 | — | $14 | 0.05% |
| KEEGAN G SMITH3 | 323 WEST 9TH STREET COLUMBIA, TN 38401 | AFLAC | $14 | — | $14 | 0.05% |
| BENEFITS GALLERY LLC3 | 705 WEST LOCUST DRIVE CHANDLER, AZ 85248 | AFLAC | $12 | — | $12 | 0.04% |
| CHARLES NELSON3 Filed as: CHARLES EDMUND NELSON | 20280 NORTH 59TH AVENUE SUITE 115-233 GLENDALE, AZ 85308 | AFLAC | $8 | — | $8 | 0.03% |
| EXEL IVAN CARABALLO JR3 | 2329 EAST BOWKER STREET PHOENIX, AZ 85040 | AFLAC | $8 | — | $8 | 0.03% |
| SHAWN HOLTORF3 | 5522 WEST NORTHWOOD DRIVE GLENDALE, AZ 85310 | AFLAC | $7 | — | $7 | 0.03% |
| DENNIS W CAMDEN3 | 715 NORTH KENTUCKY STREET MEXICO, MO 65265 | AFLAC | $6 | — | $6 | 0.02% |
| PAMELA UTTER3 Filed as: PAMELA S UTTER | 7750 WEST BOCA RATON ROAD PEORIA, AZ 85381 | AFLAC | $5 | — | $5 | 0.02% |
| JEFFREY A KLEINMAN SR3 | 3420 EAST SHEA BOULEVARD SUITE 168 PHOENIX, AZ 85028 | AFLAC | $3 | — | $3 | 0.01% |
| MICHAEL G GLADNICK3 | 3850 EAST BASELINE ROAD SUITE 116 MESA, AZ 85206 | AFLAC | $3 | — | $3 | 0.01% |
| NATALIE MALHAM3 | 3850 EAST BASELINE ROAD SUITE 116 MESA, AZ 85206 | AFLAC | $3 | — | $3 | 0.01% |
| WILLIAM J SHARP3 | 17836 NORTH 43RD WAY PHOENIX, AZ 85032 | AFLAC | $2 | — | $2 | 0.01% |
| BARBARA ANN MCNAUGHTON3 | 4910 CORPORATE DRIVE NW SUITE G HUNTSVILLE, AL 35805 | AFLAC | $2 | — | $2 | 0.01% |
| ROBERT E LABONTE3 | 1659 WEST SAN REMO STREET GILBERT, AZ 85233 | AFLAC | $2 | — | $2 | 0.01% |
| CHAD P SCHIIEDER3 Filed as: CHAD P SCHNIEDER | 360 WEST HUBBARD STREET APARTMENT 1105 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 9225 PRIORITY WAY WEST DRIVE SUITE 100 INDIANAPOLIS, IN 46240 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 16.68% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $44 | $44 | 0.34% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | AVESIS INSURANCE INCORPORATED | $964 | — | $964 | 9.32% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AVESIS INSURANCE INCORPORATED | 149 | $10K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 110 | $13K |
| Other(2 contracts, 2 carriers) | AFLAC | 110 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.