| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GARRY L JOHNSON & ASSOCIATES INC3 | 3850 E BASELINE RD MESA, AZ 85206 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GARRY L JOHNSON & ASSOCIATES INC3 | 3850 E BASELINE RD MESA, AZ 85206 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.19% |
| GARRY L JOHNSON & ASSOCIATES INC3 | 3850 E BASELINE RD MESA, AZ 85206 | ONE AMERICA | $6K | — | $6K | 6.00% |
| GARRY L JOHNSON & ASSOCIATES INC3 | 3850 E BASELINE RD MESA, AZ 85206 | ONE AMERICA | $4K | — | $4K | 6.00% |
| GARRY L JOHNSON & ASSOCIATES INC3 | 3850 E BASELINE RD MESA, AZ 85206 | ONE AMERICA | $6K | — | $6K | 8.67% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEORGETOWN RD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $187 | — | $187 | 0.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 3 | Claims processing Service code 12 | 11 SCOTT STREET SUITE 100 WAUSAU, WI 54403 | $151K |
| GARRY L JOHNSON & ASSOCIATES INC EIN 86-0616252 3 | Other commissions Service code 55 | 3850 E BASELINE ROAD MESA, AZ 85206 | $51K |
| MATRIX RISK MANAGEMENT LLC EIN 83-0360667 3 | Consulting (general) Service code 16 | 125 PRESUMPSCOT ST. FALMOUTH, ME 04105 | $15K |
| OPTUM RX EIN 33-0441200 3 | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | 11000 OPTUM CIRCLE DEEN PRAIRIE, MN 55344 | $0 |
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 | 150 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 454 | $109K |
| Vision | VISION SERVICE PLAN | 165 | $35K |
| Life insurance | ONE AMERICA | 251 | $65K |
| Short-term disability | ONE AMERICA | 208 | $92K |
| Long-term disability | ONE AMERICA | 208 | $74K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 150 | $547K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.