| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $47K | — | $47K | 14.37% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN STREET SUITE 291 RACINE, WI 53403 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $7K | $19K | 10.26% |
| GLORIA A OLSON3 | 999 EAST FRY BOULEVARD SUITE 306 SIERRA VISTA, AZ 85635 | AFLAC | $2K | $174 | $3K | 8.99% |
| KEVIN DALE HARLOW3 | 6281 NORTH ORACLE ROAD UNIT 35072 TUCSON, AZ 85740 | AFLAC | $342 | $37 | $379 | 1.32% |
| CAROL E MONTGOMERY3 | 2404 EAST DRACHMAN STREET TUCSON, AZ 85719 | AFLAC | $326 | — | $326 | 1.13% |
| ZAKERY ALLEN HARLOW3 | 4566 NORTH 1ST AVENUE SUITE 140 TUCSON, AZ 85718 | AFLAC | $222 | $37 | $259 | 0.90% |
| LESLIE J BAILEY3 | 4234 NORTH PORTAGE AVENUE MERIDIAN, ID 83646 | AFLAC | $237 | — | $237 | 0.82% |
| PATTY J NATIONS3 | PO BOX 89639 TUCSON, AZ 75752 | AFLAC | $211 | — | $211 | 0.73% |
| DONALD GREEN3 Filed as: DONALD A GREEN | 1611 WEST PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $124 | — | $124 | 0.43% |
| SCOTT WEBB3 | 2355 WEST PINNACLE PEAK ROAD SUITE 380 PHOENIX, AZ 85027 | AFLAC | $50 | $37 | $87 | 0.30% |
| MARK K HASLEY3 | 21925 NORTH 70TH AVENUE GLENDALE, AZ 85310 | AFLAC | $80 | — | $80 | 0.28% |
| SANDRA L SARFF3 | 7090 NORTH ORACLE ROAD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $59 | — | $59 | 0.21% |
| TAD H DRYDEN3 | 540 EAST CONQUEST LANE GLOBE, AZ 85501 | AFLAC | $57 | — | $57 | 0.20% |
| JACOB C ECHOLS3 | 3850 EAST BASELINE ROAD SUITE 116 MEAS, AZ 85206 | AFLAC | $52 | — | $52 | 0.18% |
| GUADALUPE PARRA3 | PO BOX 91403 TUCSON, AZ 85752 | AFLAC | $49 | — | $49 | 0.17% |
| MICHAEL LOUIS D'ANGELO3 | 8251 NORTH SUWANNEE DRIVE TUCSON, AR 85741 | AFLAC | $39 | — | $39 | 0.14% |
| ERIC PEDERSON3 | 1600 WEST UNIVERSITY AVENUE SUITE 104 FLAGSTAFF, AZ 86001 | AFLAC | $34 | — | $34 | 0.12% |
| V LAMAR ECHOLS3 | 3723 EAST WASHINGTON COURT GILBERT, AZ 85234 | AFLAC | $33 | — | $33 | 0.11% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT T ECHOLS | PO BOX 594 THATCHER, AZ 86301 | AFLAC | $33 | — | $33 | 0.11% |
| TAMMY A PEDERSON3 | 1600 WEST UNIVERSITY AVENUE SUITE 104 FLAGSTAFF, AZ 86001 | AFLAC | $30 | — | $30 | 0.10% |
| EGGERT & EDWARDS INS INC3 | 6430 NORTH CAMINO ARTURO TUCSON, AZ 85718 | AFLAC | $26 | — | $26 | 0.09% |
| MARK HILL3 | 222 WEST GURLEY STREET SUITE 214 PRESCOTT, AZ 86301 | AFLAC | $25 | — | $25 | 0.09% |
| JENNIFER GOOCH3 Filed as: JENNIFER L GOOCH | 4897 WEST HURSTON DRIVE TUCSON, AZ 85742 | AFLAC | $21 | — | $21 | 0.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $20 | — | $20 | 0.07% |
| CHAD P SCHNEIDER3 | 14430 BENEFIT STREET APARTMENT 308 SHERMAN OAKS, CA 91423 | AFLAC | $20 | — | $20 | 0.07% |
| JACKIE G BARTA3 | 3500 NORTH MALLARD CIRCLE SIERRA VISTA, AZ 85635 | AFLAC | $7 | $10 | $17 | 0.06% |
| PREFERRED MARKETING CORP3 | 7402 KINGS RIVER COURT HUMBLE, TX 77346 | AFLAC | $12 | — | $12 | 0.04% |
| JACK GATHINGS3 | 7235 SOUTH GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $11 | — | $11 | 0.04% |
| DONNA NORTHRUP3 Filed as: DONNA D NORTHRUP | 3501 NORTH FREEWAY SPACE 65 TUCSON, AZ 85705 | AFLAC | $3 | — | $3 | 0.01% |
| SHELLEY A MATSON3 | 11529 NORTH KRISCOTT COURT TUCSON, AZ 85737 | AFLAC | $1 | — | $1 | 0.00% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | — | EMPLOYERS DENTAL SERVICES | $1K | — | $1K | 8.00% |
| CSA GENERAL INSURANCE AGENCY3 | 2480 WEST LAS PALMARITAS PHOENIX, AZ 85021 | EYEMED VISION CARE | $2K | — | $2K | 14.05% |
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) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 191 | $330K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $200K |
| Vision | EYEMED VISION CARE | 245 | $13K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $185K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $185K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $185K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.