| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SETH G KNOWLTON3 | PO BOX 68766 TUCSON, AZ 85737 | AFLAC | $25K | $2K | $27K | 5.73% |
| ZAKERY ALLEN HARLOW3 | 3755 N BUSINESS CENTER DR TUCSON, AZ 85705 | AFLAC | $8K | $821 | $9K | 1.94% |
| MABY JANNETT SANORA3 | 3481 W AVENIDA SOMBRA TUCSON, AZ 85746 | AFLAC | $6K | $118 | $6K | 1.36% |
| LAUREL L HARLOW3 | 3755 N BUSINESS CENTRE DR TUCSON, AZ 85705 | AFLAC | $6K | $36 | $6K | 1.19% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $5K | — | $5K | 1.08% |
| H LARAINE OLIPHANT3 | 3580 WEST INA ROAD SUITE 150 TUCSON, AZ 85741 | AFLAC | $3K | — | $3K | 0.66% |
| KIMBERLY J RODRIGUEZ3 | 37057 S GAMBEL QUAIL DRIVE MARANA, AZ 85658 | AFLAC | $3K | $381 | $3K | 0.63% |
| ROBERT E LABONTE3 | 1659 WEST SAN REMO STREET GILBERT, AZ 85233 | AFLAC | $3K | — | $3K | 0.58% |
| RACHEL DAY3 Filed as: RACHEL S DAY | 5533 E 24TH STREET TUCSON, AL 85711 | AFLAC | $2K | $441 | $3K | 0.56% |
| DAVID GODDARD3 Filed as: DAVID L GODDARD | 2840 N GRANNEN ROAD TUCSON, AZ 85746 | AFLAC | $2K | $353 | $2K | 0.51% |
| SANDRA L SARFF3 | 7090 N ORACLE ROAD 178 PMB 152 TUCSON, AZ 85704 | AFLAC | $2K | — | $2K | 0.51% |
| LAUREL L HARLOW3 | 4566 N 1ST AVE SUITE 140 TUCSON, AZ 85718 | AFLAC | $2K | — | $2K | 0.44% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60675 | AFLAC | $2K | — | $2K | 0.44% |
| ARIZONA BENEFIT PLANS INC3 | ONE EAST CAMELBACK ROAD SUITE 840 PHOENIX, AL 85012 | AFLAC | $2K | — | $2K | 0.43% |
| SCOTT WEBB3 | 2355 W PINNACLE PEAK ROAD SUITE 380 PHOENIX, AZ 85027 | AFLAC | $1K | $752 | $2K | 0.42% |
| JENNIFER ELLEN3 | 372 WISTERIA AVENUE LAS VEGAS, NV 89107 | AFLAC | $2K | — | $2K | 0.36% |
| DAMON ENGLISH3 Filed as: DAMON W ENGLISH | 27014 N 52ND GLEN PHOENIX, AL 85083 | AFLAC | $1K | — | $1K | 0.31% |
| JANELL R FRANK3 | 7571 N RAE AVENUE TUCSON, AZ 85741 | AFLAC | $1K | $106 | $1K | 0.24% |
| GREGORY STENZEL3 Filed as: GREGORY P STENZEL | 2302 KNOX WAY MELISSA, TX 75454 | AFLAC | $998 | — | $998 | 0.21% |
| DONALD GREEN3 Filed as: DONALD A GREEN | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $960 | — | $960 | 0.21% |
| PAUL B BROUCHOUD3 | 604 MARK DRIVE DEL CITY, OK 73115 | AFLAC | $846 | — | $846 | 0.18% |
| GLEN DOUGLAS GABLE3 | E BASELINE ROAD SUITE 116 MESA, AZ 85206 | AFLAC | $772 | — | $772 | 0.16% |
| DONNA HERNANDEZ3 Filed as: DONNA L HERNANDEZ | 1172 N DAVID DRIVE NOGALES, AZ 85621 | AFLAC | $393 | $329 | $722 | 0.15% |
| CAROLYN SUE BRASSARD3 | 4400 E HAVEN LANE TUCSON, AZ 85712 | AFLAC | $721 | — | $721 | 0.15% |
| PATRICIA J GEE3 | PO BOX 233 MESA, AZ 85214 | AFLAC | $629 | — | $629 | 0.13% |
| BRITTON JOHNSON3 Filed as: BRITTON L JOHNSON | 1069 W BROAD STREET SUITE 153 FALLS CHURCH, VA 22046 | AFLAC | $593 | — | $593 | 0.13% |
| DENNIS W CAMDEN3 | 225 LAKE ESTATES TRARIL LONGVIEW, TX 75605 | AFLAC | $549 | — | $549 | 0.12% |
| SHARON MALONE3 | 10719 E FLORIAN AVENUE MESA, AZ 85206 | AFLAC | $536 | — | $536 | 0.11% |
| JOSEPH GARCIA3 Filed as: JOSEPH RICHARDO GARCIA | 2101 N SANDARIO ROAD TUCSON, AZ 85743 | AFLAC | $361 | $156 | $517 | 0.11% |
| LINDA GREEN3 Filed as: LINDA R GREEN | 1081 S DUTCH JOHN SPRING COURT GREEN VALLEY, AZ 85614 | AFLAC | $515 | — | $515 | 0.11% |
| MICHAEL FATHERREE3 | 11876 MOORHEN CIR FORT WORTH, TX 76244 | AFLAC | $447 | — | $447 | 0.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $439 | — | $439 | 0.09% |
| PREFERRED MARKETING CORP3 | 1194 E LAKEVIEW DR SAN TAN VALLEY, AZ 85143 | AFLAC | $373 | — | $373 | 0.08% |
| DESERT INSURANCE ADVISORS LLC3 | 3219 E CAMELBACK ROAD #396 PHOENIX, AL 85018 | AFLAC | $350 | — | $350 | 0.07% |
| MICHAEL D SCHULTZ3 | 1615 14TH STREET NW ROCHESTER, ME 55901 | AFLAC | $338 | — | $338 | 0.07% |
| JOHN F HILDENBRAND3 | 7330 E PLACITA POSITIVO TUCSON, AZ 85715 | AFLAC | $101 | $174 | $275 | 0.06% |
| MARK HILL3 | PO BOX 85715 TUCSON, AZ 85754 | AFLAC | $275 | — | $275 | 0.06% |
| APRIL L FARRELL3 | 14301 N 87TH ST STE 313 SCOTTSDALE, AZ 85260 | AFLAC | $272 | — | $272 | 0.06% |
| CHAD P SCHNEIDER3 | 14430 BENEFIT ST APT 308 SHERMAN OAKS, CA 91423 | AFLAC | $233 | — | $233 | 0.05% |
| MARK HILL3 | 7673 N SUMMIT PASS PRESCOTT VALLEY, AZ 86315 | AFLAC | $226 | — | $226 | 0.05% |
| PAMELA UTTER3 Filed as: PAMELA S UTTER | 7750 W BOCA RATON RD PEORIA, AZ 85381 | AFLAC | $178 | — | $178 | 0.04% |
| PHILLIP BRENFLECK3 Filed as: PHILLIP MALCOLM BRENFLECK | 7887 E UHL ST APT 1008 TUCSON, AL 85710 | AFLAC | $85 | $68 | $153 | 0.03% |
| M JEAN HEMP3 | PO BOX 41292 MESA, AZ 85274 | AFLAC | $143 | — | $143 | 0.03% |
| DARA L WYCKOFF3 | 505 N ARGONNE BLDG C SPOKANE VALLEY, WA 99212 | AFLAC | $135 | — | $135 | 0.03% |
| MERLE DALE HALL3 | 950 W BANNOCK ST SUITE 1100 BOISE, ID 83702 | AFLAC | $128 | — | $128 | 0.03% |
| HARRIETTE FOX3 | 25842 S DARTFORD DRIVE SUN LAKES, AL 85248 | AFLAC | $111 | — | $111 | 0.02% |
| WILLIAM BRENT MILLER3 | 2604 S PLAYA MESA, AZ 85202 | AFLAC | $106 | — | $106 | 0.02% |
| GILBERT VELASCO3 Filed as: GILBERT E VELASCO | 2563 W CALLE PUEBLA TUCSON, AZ 85745 | AFLAC | $88 | $18 | $106 | 0.02% |
| NED BILECKI3 Filed as: NED A BILECKI | PO BOX 27567 TEMPE, AZ 85285 | AFLAC | $75 | — | $75 | 0.02% |
| RICHARD KELLIHER3 | 10533 E COSMOS CIRCLE SCOTTSDALE, AZ 85255 | AFLAC | $69 | — | $69 | 0.01% |
| DIANA VIDISKY3 Filed as: DIANA N VIDISKY | 3365 NORTH VIEW CREST DRIVE TUCSON, AZ 85745 | AFLAC | $57 | — | $57 | 0.01% |
| KATHY LEE BRIGHT3 | 788 E PEPPER DRIVE CASA GRANDE, AZ 85122 | AFLAC | $48 | — | $48 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 160 W SANTA CLARA STREET SUITE 450 SAN JOSE, CA 95113 | AFLAC | $43 | — | $43 | 0.01% |
| SHARON MCKELVEY3 Filed as: SHARON I MCKELVEY | 30969 N MUSCOVITE DRIVE SAN TAN VALLEY, AZ 85143 | AFLAC | $41 | — | $41 | 0.01% |
| HAROLD W ELLIOTT LLC3 | 15838 S 1ST AVE PHOENIX, AZ 85045 | AFLAC | $34 | — | $34 | 0.01% |
| WILLIAM BRENT MILLER3 | 1222 W BASELINE RD UNIT 245 TEMPE, AZ 85283 | AFLAC | $34 | — | $34 | 0.01% |
| TABITHA R SPARKS3 | 2715 N 25TH STREET PHOENIX, AZ 85008 | AFLAC | $32 | — | $32 | 0.01% |
| DEANNA M LUJAN3 | 921 W SAN MARCOS DRIVE CHANDLER, AL 85225 | AFLAC | $32 | — | $32 | 0.01% |
| XPONENT EMPLOYER SOLUTIONS INC3 | 14500 N NORTHSIGHT BLVD SUITE 108 SCOTTSDALE, AZ 85260 | AFLAC | $28 | — | $28 | 0.01% |
| MARIA MULLIGAN3 | 19420 N 59TH AVE STE C251 GLENDALE, AZ 85308 | AFLAC | $23 | — | $23 | 0.00% |
| PHILLIP BRENFLECK3 Filed as: PHILLIP MALCOLM BRENFLECK | 7887 E UHL ST APT 1008 TUCSON, AZ 85710 | AFLAC | $21 | — | $21 | 0.00% |
| JAMES HARVEY3 Filed as: JAMES VELMORE HARVEY | 1091 W CALLE EXCELSO GREEN VALLEY, AL 85614 | AFLAC | $18 | — | $18 | 0.00% |
| ALAN HOFFMAN3 Filed as: ALAN K HOFFMAN | 7615 E CALLE LOS ARBOLES TUCSON, AZ 85750 | AFLAC | $18 | — | $18 | 0.00% |
| JASON D MILLER3 | 3553 VICTORIA MANOR LN APT 107 LAKELAND, FL 33805 | AFLAC | $12 | — | $12 | 0.00% |
| EXEL IVAN CARABALLO JR3 | 2929 N 37TH STREET APT 6 PHOENIX, AZ 85018 | AFLAC | $12 | — | $12 | 0.00% |
| MULLIGAN BENEFITS LLC3 | 2355 W PINNACLE PEAK RD STE 380 PHOENIX, AZ 85027 | AFLAC | $11 | — | $11 | 0.00% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $10 | — | $10 | 0.00% |
| DEBORAH A BRIGHTSTAR3 | 8019 S QUEEN CREEK DR TUCSON, AZ 85747 | AFLAC | $10 | — | $10 | 0.00% |
| BRYAN TUCKER3 Filed as: BRYAN D TUCKER | 24654 NORTH LAKE PLEASANT PARKWAY 103-466 PEORIA, AZ 85383 | AFLAC | $7 | — | $7 | 0.00% |
| MULLIGAN BENEFITS LLC3 | 19420 N 59TH AVE SUITE C251 GLENDALE, AL 85306 | AFLAC | $4 | — | $4 | 0.00% |
| MARREEL SLATER INSURANCE LLC3 | 7855 S RIVER PKWY STE 210 TEMPE, AZ 85284 | AFLAC | $4 | — | $4 | 0.00% |
| PHILIP TAVASCI3 Filed as: PHILIP DANTE TAVASCI | 5450 E HIGH STREET 300 PHOENIX, AL 85054 | AFLAC | $2 | — | $2 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $10K | $17K | 4.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $7K | $10K | 7.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $359K |
| JORGENSEN HEALTHCARE ASSOC. EIN 86-0687859 EAP PROVIDER | Other services Service code 49 | — | $36K |
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 | 1,164 | 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) | 1,164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 837 | $92K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,164 | $512K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 1,164 | $844K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,164 | $376K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,135 | $443K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,164 | $512K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,164 | — |
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.