| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT INTELLIGENCE INC3 | 4862 E BASELINE RD., STE 101 MESA, AZ 85206 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 7.02% |
| GREGG FENDLEY BENEFITS INC3 | 940 N. SWITZER CANYON DR. #202 FLAGSTAFF, AZ 86001 | METROPOLITAN LIFE INSURANCE COMPANY | $115 | $129 | $244 | 0.39% |
| JAMES JOBLON JR3 | 960 NW FRESCO WAY APT 102 JENSEN BEACH, FL 34957 | AFLAC | $302 | $5 | $307 | 4.31% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $67 | — | $67 | 0.94% |
| MISSY LEFFLER3 | 457 S 98TH PL MESA, AZ 85208 | AFLAC | $40 | — | $40 | 0.56% |
| SCOTT WEBB3 | 12366 W MILTON DR PEORIA, AZ 85383 | AFLAC | $35 | — | $35 | 0.49% |
| RICA GIRARDI3 | 5346 BRANDING IRON LOOP PINETOP, AZ 85935 | AFLAC | $31 | $2 | $33 | 0.46% |
| SUZANNE ROWE3 | 5763 E EL CAMINO QUINTO APACHE JUNCTION, AZ 85119 | AFLAC | $33 | — | $33 | 0.46% |
| BENEFIT INTELLIGENCE INC3 | 4862 E BASELINE RD STE 101 MESA, AZ 85202 | AFLAC | $24 | — | $24 | 0.34% |
| RICK GOODMAN3 | PO BOX 42 SHOW LOW, AZ 85902 | AFLAC | $23 | — | $23 | 0.32% |
| LANCE POWELL SR3 | 760 N 6TH AVE SHOW LOW, AZ 85901 | AFLAC | $19 | — | $19 | 0.27% |
| ERIC PEDERSON3 | 2615 N 4TH ST STE 1 FLAGSTAFF, AZ 86004 | AFLAC | $11 | $5 | $16 | 0.22% |
| JACOB C ECHOLS3 Filed as: JACOB ECHOLS | 3850 E BASELINE RD STE 116 MESA, AZ 85206 | AFLAC | $11 | — | $11 | 0.15% |
| WILLIAM H LENBERG3 Filed as: WILLIAM LENBERG | 10920 FAROLA DR NW ALBUQUERQUE, NM 87114 | AFLAC | $10 | — | $10 | 0.14% |
| JAMES HUNT3 | 15010 N 61ST PL SCOTTSDALE, AZ 85254 | AFLAC | $9 | — | $9 | 0.13% |
| MATTHEW MONK3 | PO BOX 3205 SHOW LOW, AZ 85902 | AFLAC | $8 | — | $8 | 0.11% |
| CHAD P SCHNEIDER3 Filed as: CHAD SCHNEIDER | 360 W HUBBARD ST APT 1105 CHICAGO, IL 60654 | AFLAC | $7 | — | $7 | 0.10% |
| TOM KOCH3 | 1800 NE 48TH CT FT LAUDERDALE, FL 33308 | AFLAC | $5 | — | $5 | 0.07% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR SAN TAN VALLEY, AZ 85143 | AFLAC | $5 | — | $5 | 0.07% |
| SANDRA L SARFF3 Filed as: SANDRA SARFF | 7090 N ORACLE RD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $5 | — | $5 | 0.07% |
| GEORGANNE JANNENGA3 | 2381 W PIONEER CT SHOW LOW, AZ 85901 | AFLAC | $5 | — | $5 | 0.07% |
| J M ELLWOOD3 Filed as: J ELLWOOD | 8220 E SAN MIGUEL AVE SCOTTSDALE, AZ 85250 | AFLAC | $3 | — | $3 | 0.04% |
| SHAWN HOLTORF3 | 5522 W NORTHWOOD DR GLENDALE, AZ 85310 | AFLAC | $3 | — | $3 | 0.04% |
| JEFFREY A KLEINMAN SR3 Filed as: JEFFREY KLEINMAN SR | 3420 SHEA BLVD STE 168 PHOENIX, AZ 85028 | AFLAC | $3 | — | $3 | 0.04% |
| ZAKERY HARLOW3 | 3204 N ACADEMY BLVD STE 130 COLORADO SPRINGS, CO 80917 | AFLAC | $2 | — | $2 | 0.03% |
| BARBARA ANN MCNAUGHTON3 Filed as: BARBARA MCNAUGHTON | 1308 NATURE WALK BLVD SW HUNTSVILLE, AL 35824 | AFLAC | $2 | — | $2 | 0.03% |
| JEFFERY S GIBSON3 Filed as: JEFFERY GIBSON | 4805 LAKE BROOK DR STE 220 GLEN ALLEN, VA 23060 | AFLAC | $2 | — | $2 | 0.03% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $2 | — | $2 | 0.03% |
| SHARON MCKELVEY3 | 197 N NOTTINGHAM LN LOT 3 PAYSON, AZ 85541 | AFLAC | $1 | — | $1 | 0.01% |
| JOHN BURLEY3 | 3060 W CALLE LUCINDA TUCSON, AZ 85741 | AFLAC | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUMMIT ADMINISTRATION SERVICES, INC EIN 86-0836639 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | PO BOX 25160 SCOTTSDALE, AZ 85255 | $10K |
| BLUE CROSS BLUE SHIELD OF ARIZONA EIN 86-0004538 PROVIDER NETWORK ACCESS | Other fees Service code 99 | 2444 WEST PALOMAS DRIVE PHOENIX, AZ 85002 | $10K |
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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $63K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $63K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $63K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $63K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $63K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 144 | $85K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 682 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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."
No prospect flags tripped on this filing.