| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | BLUE CROSS BLUE SHIELD OF ARIZONA | $36K | $0 | $36K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BENEFIT COMMERCE GROUP LLC | 14300 NORTH NORTHSIGHT BOULEVARD SUITE 221 SCOTTSDALE, AZ 85260 | BLUE CROSS BLUE SHIELD OF ARIZONA | -$187 | $0 | -$187 | -0.03% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $346 | $3K | 15.77% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $258 | $22 | $280 | 1.56% |
| EXCEL IVAN CARABALLO JR3 | 2329 EAST BOWKER STREET PHOENIX, AZ 85040 | AFLAC | $213 | $67 | $280 | 2.61% |
| GLEN DOUGLAS GABLE3 | 3521 SOUTH CAMELLIA PLACE CHANDLER, AZ 75248 | AFLAC | $239 | $0 | $239 | 2.23% |
| RICHARD STRASZEWSKI AND MISC AGENTS3 | 23722 SOUTH ILLINOIS AVENUE SUN LAKES, AZ 85248 | AFLAC | $166 | $17 | $183 | 1.70% |
| DAVID R LATTIMER3 | 3029 NORTH SONORAN HILLS MESA, AZ 85207 | AFLAC | $150 | $17 | $167 | 1.56% |
| PAMELA UTTER3 Filed as: PAMELA S UTTER | 7750 WEST BOCA RATON ROAD PEORIA, AZ 85381 | AFLAC | $141 | $0 | $141 | 1.31% |
| ROBERT E LABONTE3 | 1659 WEST SAN REMO STREET GILBERT, AZ 85233 | AFLAC | $104 | $17 | $121 | 1.13% |
| THE SPELLICY GROUP3 Filed as: THE SPELLICY GROUP INC | 29834 NORTH CAVE CREEK ROAD SUITE 118 CAVE CREEK, AZ 85331 | AFLAC | $71 | $0 | $71 | 0.66% |
| JOHNSON INSURANCE SERVICES LLC3 | 318 SOUTH WASHINGTON STREET SUITE 200 GREEN BAY, WI 54301 | VISION SERVICE PLAN | $702 | $0 | $702 | 7.77% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 76 | $668K |
| Dental | STANDARD INSURANCE COMPANY | 83 | $43K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ARIZONA | 76 | $677K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $18K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 76 | $668K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 86 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.