| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN JAMES GRADY3 | 555 MAIN ST STE 291 RACINE, WI 53403 | UNITED HEALTHCARE INSURANCE COMPANY | — | $10K | $10K | 0.81% |
| MONTEREY BENEFITS LLC3 | 8700 E PINNACLE PEAK RD SCOTTSDALE, AZ 85255 | UNITED HEALTHCARE INSURANCE COMPANY | — | $8K | $8K | 0.65% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST STE 291 RACINE, WI 53403 | UNITED HEALTHCARE INSURANCE COMPANY | — | $6K | $6K | 0.49% |
| MICHAEL DERDZINSKI3 | JOHNSON INSURANCE SERVICES LLC 555 MAIN ST #291 RACINE, WI 53403 | DELTA DENTAL OF ARIZONA | $7K | — | $7K | 6.07% |
| MONTEREY BENEFITS LLC3 | 9150 E DEL CAMINO DR SUITE 112 SCOTTSDALE, AZ 85258 | DELTA DENTAL OF ARIZONA | $2K | — | $2K | 1.94% |
| MONTEREY BENEFITS LLC3 | 9150 E DEL CAMINO DR #112 SCOTTSDALE, AZ 852584317 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST STE 291 RACINE, WI 534031000 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 6.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 525 JUNCTION RD MADISON, WI 53717 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.69% |
| MONTEREY BENEFITS LLC3 Filed as: MONTEREY BENEFITS, LLC | 9150 E DEL CAMINO DR STE 112 SCOTTSDALE, AZ 85258 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST STE 291 RACINE, WI 53403 | VISION SERVICE PLAN | $721 | — | $721 | 5.76% |
| MONTEREY BENEFITS LLC3 Filed as: MONTEREY BENEFITS, LLC | 9150 EAST DEL CAMINO DR., STE 112 SCOTTSDALE, AZ 852584317 | VISION SERVICE PLAN | $137 | — | $137 | 1.09% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INS SERVICE LLC | 9150 E DEL CAMINO SCOTTSDALE, AZ 85258 | MAGELLAN BEHAVIORAL HEALTH | $263 | — | $263 | 5.96% |
| MONTEREY BENEFITS LLC3 Filed as: MONTEREY BENEFITS, LLC | 9150 E. DEL CAMINO DR., SUITE 112 SCOTTSDALE, AZ 85258 | MAGELLAN BEHAVIORAL HEALTH | $131 | — | $131 | 2.97% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 229 | $1.2M |
| Dental | DELTA DENTAL OF ARIZONA | 138 | $110K |
| Vision | VISION SERVICE PLAN | 71 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 140 | $91K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 140 | $91K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 140 | $91K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 140 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.