| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| APRIL L FARRELL3 | 14301 NORTH 87TH STREET SUITE 313 SCOTTSDALE, AZ 85260 | AFLAC | $7K | $322 | $7K | 11.20% |
| DANIEL SALDIVAR JR3 | 433 KITTY HAWK DRIVE BUILDING 2 SUITE 215 UNIVERSAL CITY, TX 78148 | AFLAC | $4K | $77 | $4K | 5.63% |
| MICHAEL W. POWER3 Filed as: MICHAEL W POWER | 3427 PECAN GAP SAN ANTONIO, TX 78247 | AFLAC | $3K | $56 | $3K | 4.53% |
| DENISE JANE FORCONI3 | 30411 NORTH 72ND PLACE SCOTTSDALE, AZ 85266 | AFLAC | $2K | $64 | $2K | 2.55% |
| JEFFERY S GIBSON3 | 14301 NORTH 87TH STREET SUITE 313 SCOTTSDALE, AZ 85260 | AFLAC | $779 | — | $779 | 1.17% |
| BRENT FORD3 Filed as: BRENT A FORD | 40 NE LOOP 410 SUITE 408 SAN ANTONIO, TX 78216 | AFLAC | $741 | $22 | $763 | 1.15% |
| PATRICIA J GEE3 | P.O. BOX 2334 MESA, AZ 85214 | AFLAC | $581 | — | $581 | 0.88% |
| BRITTON JOHNSON3 Filed as: BRITTON L JOHNSON | 1069 WEST BROAD STREET SUITE 153 FALLS CHURCH, VA 22046 | AFLAC | $314 | $64 | $378 | 0.57% |
| MARVIN LEE WILKERSON3 | 884 HOLLY TREE GAP ROAD BRENTWOOD, TN 37027 | AFLAC | $283 | — | $283 | 0.43% |
| SCOTT WEBB3 | 2355 WEST PINNACLE PEAK ROAD SUITE 380 PHOENIX, AZ 85027 | AFLAC | $118 | $57 | $175 | 0.26% |
| M JEAN HEMP3 | P.O. BOX 41292 MESA, AZ 85274 | AFLAC | $97 | — | $97 | 0.15% |
| NICHOLAS E VIGIL3 | 100 CADILLAC DRIVE APARTMENT 24 SACRAMENTO, CA 95825 | AFLAC | $86 | — | $86 | 0.13% |
| GARY A YARBROUGH3 | 1436 NORTH HIGLEY ROAD APARTMENT 100 GILBERT, AZ 85234 | AFLAC | $78 | — | $78 | 0.12% |
| MICHAEL L BRAUN3 | 1718 DEVOE DRIVE LINCOLN, NE 68506 | AFLAC | $73 | — | $73 | 0.11% |
| MERLE DALE HALL3 | 950 WEST BANNOCK STREET SUITE 1100 BOISE, ID 83702 | AFLAC | $64 | — | $64 | 0.10% |
| ORIN LEE WILLIAMS3 | 5467 EAST WOODSTOCK ROAD CAVE CREEK, AZ 85331 | AFLAC | $44 | — | $44 | 0.07% |
| GREGORY J WEEKS3 | 1259 LOOP 337 SECOND FLOOR NEW BRAUNFELS, TX 78130 | AFLAC | $18 | $22 | $40 | 0.06% |
| GREGORY F STENZEL3 | 2302 KNOX WAY MELISSA, TX 75454 | AFLAC | $37 | — | $37 | 0.06% |
| PREFERRED MARKETING CORP3 | 1194 EAST LAKEVIEW DRIVE SAN TAN VALLEY, AZ 85143 | AFLAC | $36 | — | $36 | 0.05% |
| EFRAIN RENE DIAZ3 | 6287 EAST AVALON DRIVE SCOTTSDALE, AZ 85251 | AFLAC | $30 | — | $30 | 0.05% |
| DENNIS W CAMDEN3 | 225 LAKE ESTATES TRAIL LONGVIEW, TX 75605 | AFLAC | $23 | — | $23 | 0.03% |
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | 2730 EAST CAMELBACK ROAD SUITE 100 PHOENIX, AZ 85016 | AETNA LIFE INSURANCE COMPANY | $5K | — | $5K | 8.64% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | P.O. BOX 50435 INDIANAPOLIS, IN 462500435 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 12.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 850182614 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE, INC. | P.O. BOX 50435 INDIANAPOLIS, IN 46250 | EYEMED | $986 | — | $986 | 10.95% |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 163 | $59K |
| Vision | EYEMED | 125 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 108 | $20K |
| Short-term disability | AFLAC | 79 | $66K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 23 | $11K |
| Other | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 108 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.