| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| APRIL L FARRELL3 | 4515 SOUTH MCLINTOCK DRIVE SUITE 212 TEMPE, AZ 85282 | AFLAC | $2K | $223 | $3K | 7.51% |
| MJ INSURANCE3 Filed as: M JEAN HEMP AND VARIOUS AGENTS | PO BOX 41292 MESA, AZ 85274 | AFLAC | $1K | $40 | $1K | 3.07% |
| GEORGE PADRON3 | 11 SOUTH CENTRAL AVENUE APARTMENT, AZ 85004 | AFLAC | $428 | $45 | $473 | 1.37% |
| MICHAEL BACKHOFF3 Filed as: MICHAEL BACKOFF | 906 BRADFORD AVENUE NASHVILLE, TN 37204 | AFLAC | $322 | $0 | $322 | 0.93% |
| DENISE JANE FORCONI | 5065 EAST MAZATZAL NASHVILLE, TN 37204 | AFLAC | $313 | $0 | $313 | 0.91% |
| MARVIN LEE WILKERSON3 | 884 HOLLY TREE GAP ROAD BRENTWOOD, TN 37027 | AFLAC | $193 | $0 | $193 | 0.56% |
| FILIPE A COELHO3 | 4514 SOUTH MCCLINTOCK SUITE 212 TEMPE, AZ 85282 | AFLAC | $146 | $5 | $151 | 0.44% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 16.24% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $18 | $18 | 0.12% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $14 | $14 | 0.09% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 50435 INDIANAPOLIS, IN 46250 | AVESIS INSURANCE INCORPORATED | $993 | $0 | $993 | 10.70% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AVESIS INSURANCE INCORPORATED | 157 | $9K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 118 | $15K |
| Other(2 contracts, 2 carriers) | AFLAC | 118 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.