| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CMC ADVISORY GROUP3 | 221 N. LA SALLE SUITE 1850 CHICAGO, IL 52004 | AETNA LIFE INSURANCE CO | $87K | — | $87K | 5.13% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC. | PO BOX 28 300 SECURITY BUILDING DUBUQUE, IA 10170 | AETNA LIFE INSURANCE CO | $61K | — | $61K | 3.59% |
| JOHN GABRIEL JOLLY3 | 1229 N. CEDAR STREET GLENDALE, CA 91207 | AFLAC | $9K | $42 | $9K | 9.12% |
| RUSSELL W STANBERRY3 | 1 S FAIR OAKS AVE STE 200 PASADENA, CA 91105 | AFLAC | $7K | $54 | $7K | 6.82% |
| ELIZABETH A LENZO3 | 265 W NAOMI AVE ARCADIA, CA 91007 | AFLAC | $3K | — | $3K | 3.41% |
| AXEL DUBON3 | 2877 WOODSORREL DRIVE CHINO HILLS, CA 91709 | AFLAC | $3K | — | $3K | 2.82% |
| DANIEL E ELLIS3 Filed as: DANIEL ELLIS | 265 W NAOMI AVE ARCADIA, CA 91007 | AFLAC | $2K | $258 | $2K | 2.46% |
| BRENDA A HUERTA3 | 28160 MCBEAN PKWY UNIT 15101 VALENCIA, CA 91354 | AFLAC | $2K | $60 | $2K | 2.06% |
| MARAL DEROHANESSIAN3 | 821 S COLUMBUS AVE GLENDALE, CA 91204 | AFLAC | $2K | $10 | $2K | 1.92% |
| DESIREE DEWYSE3 | 451 N SUMMIT AVE PASADENA, CA 91103 | AFLAC | $2K | — | $2K | 1.67% |
| CARLOS GARCIA3 | 1034 N KINGSLEY DRIVE APT. 11 LOS ANGELES, CA 90029 | AFLAC | $2K | $22 | $2K | 1.66% |
| MICHELLE TROY3 | 2972 FAIR OAKS AVE ALTADENA, CA 91001 | AFLAC | $1K | — | $1K | 1.49% |
| CLAUDIA VINE3 | PO BOX 34174 GRANADA HILLS, CO 91394 | AFLAC | $1K | — | $1K | 1.31% |
| KEVIN MICHAEL NAGLE3 | 8200 MCCONNELL AVE LOS ANGELES, CA 90045 | AFLAC | $1K | — | $1K | 1.25% |
| LESLIE R WOODS3 | 623 SPIRIT LAKE HWY CASTLE ROCK, WA 98611 | AFLAC | $1K | — | $1K | 0.99% |
| MANUEL S SOLANO3 | 14616 BINNEY STREET HACIENDA HEIGHTS, CA 91745 | AFLAC | $668 | — | $668 | 0.66% |
| MICHELLE C. LEE3 Filed as: MICHELLE C LEE | 1044 LOMA LISA LANE ARCADIA, CA 91006 | AFLAC | $370 | $85 | $455 | 0.45% |
| ALEX L. PEREZ3 Filed as: ALEX L PEREZ | 4169 MONTEREY AVE BALDWIN PARK, CA 91706 | AFLAC | $370 | $2 | $372 | 0.37% |
| STANLEY S SCOTT3 | 355 S. MARENGO AVENUE SUITE 408 PASADENA, CA 91101 | AFLAC | $339 | — | $339 | 0.34% |
| MARSHALL CHARLES MCDONALD3 | 1990 N. ALTADENA DRIVE PASADENA, CA 91107 | AFLAC | $292 | $3 | $295 | 0.29% |
| MJR INSURANCE SERVICES LLC3 | 7349 PONCE AVENUE WEST HILLS, CA 91307 | AFLAC | $270 | — | $270 | 0.27% |
| KATHY DUFFY INSURANCE SERVICES3 | 10442 ORMOND STREET SHADOW HILLS, CA 91040 | AFLAC | $245 | $3 | $248 | 0.25% |
| SPALDING GROUP ENTERPRISES3 | 4297 KLUMP AVE STUDIO CITY, CA 91602 | AFLAC | $178 | — | $178 | 0.18% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $118 | — | $118 | 0.12% |
| MARIAN A LOPEZ3 | 13322 CITICOURT LANE WHITTIER, CA 90602 | AFLAC | $82 | — | $82 | 0.08% |
| HOWARD FEIGENBAUM3 | 8747 DUVAL LANE HEMET, CA 92545 | AFLAC | $61 | — | $61 | 0.06% |
| TODD V MASON3 | 6164 LAWRENCE STREET CYPRESS, CA 90630 | AFLAC | $44 | — | $44 | 0.04% |
| PRISCILLA BERNICE ARAGON3 | 7307 CATALPA AVE CALIFORNIA, CA 93505 | AFLAC | $27 | — | $27 | 0.03% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | AFLAC | $18 | — | $18 | 0.02% |
| ADAM H MICHAELS3 | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $4 | $3 | $7 | 0.01% |
| ALFRED RIETKERK3 | 3120 NE 47TH STREET FT. LAUDERDALE, FL 33308 | AFLAC | $3 | — | $3 | 0.00% |
| SARAH CHIESA3 | 7838 W RASCHER AVENUE CHICAGO, IL 60856 | AFLAC | $2K | $60 | $2K | 4.21% |
| CHRISTINA L MALOVANY3 | 2001 BUTTERFIELD ROAD, STE 1200 DOWNER GROVE, IL 60515 | AFLAC | $547 | $56 | $603 | 1.47% |
| VERONICA MEDINA3 | 1740 W 48TH STREET CHICAGO, IL 60609 | AFLAC | $504 | $39 | $543 | 1.33% |
| SCALETTA INSURANCE AGENCY INC3 Filed as: SCALETTA INSURANCE AGENCY INC. | 4552 N OTTAWA AVENUE NORRIDGE, IL 60706 | AFLAC | $485 | $20 | $505 | 1.23% |
| HENRY J SAMAAN3 | 4415 HARRISON STREET SUITE 503 HILLSIDE, IL 60162 | AFLAC | $333 | — | $333 | 0.81% |
| ORLANDO R DOBRINCU3 | 15419 W 127TH STREET LEMONT, IL 60439 | AFLAC | $301 | — | $301 | 0.74% |
| JEREMY M SKEETERS3 | 23645 N 55TH DRIVE GLENDALE, AZ 85310 | AFLAC | $162 | $20 | $182 | 0.45% |
| CRUZITA ORTIZ HAERLE3 | 4119 CORNFLOWER ROAD POPLAR GROVE, IL 61065 | AFLAC | $140 | — | $140 | 0.34% |
| MARK D BARBIER3 | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $102 | $20 | $122 | 0.30% |
| WAYNE R BALL3 | 3088 HILLBROOK LANE, APT. 104 AURORA, IL 60502 | AFLAC | $100 | $11 | $111 | 0.27% |
| ERIKA M TORRES3 | 2827 S 59TH CT., #1 #1 CICERO, IL 60804 | AFLAC | $106 | — | $106 | 0.26% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 W ERIE STREET STE 400 CHICAGO, IL 80654 | AFLAC | $104 | — | $104 | 0.25% |
| ELENI A NIKOLAS3 Filed as: ELENI A KRAUSE | 50 HURT PLZ SE STE 995 THE HURT BUILDING ATLANTA, GA 30303 | AFLAC | $92 | — | $92 | 0.22% |
| ROBERT E MAYBERRY3 | 39W418 ARMSTRONG LANE GENEVA, IL 60134 | AFLAC | $91 | — | $91 | 0.22% |
| MICHAEL A ORTIZ3 | 3433 VOLTAIRE LANE ST. CHARLES, IL 60175 | AFLAC | $84 | — | $84 | 0.21% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELT ROAD SUITE 203 WEST CHICAGO, IL 60185 | AFLAC | $62 | $11 | $73 | 0.18% |
| DENNIS J CASSENS3 | 3422 COLONY BAY DRIVE SUITE 1 ROCKFORD, IL 61109 | AFLAC | $54 | — | $54 | 0.13% |
| RONALD E HAERLE3 | 4119 CORNFLOWER ROAD POPLAR GROVE, IL 61065 | AFLAC | $52 | — | $52 | 0.13% |
| STEPHANIE DROUGAS3 | 10711 N CHURCH STREET HUNTLEY, IL 60142 | AFLAC | $49 | — | $49 | 0.12% |
| ELISEO RIVERA3 | 4119 CORNFLOWER ROAD POPLAR GROVE, IL 61065 | AFLAC | $47 | — | $47 | 0.11% |
| EDGAR E PUNTI3 | 5004 N SPRINGFIELD AVE FL 2 CHICAGO, IL 60625 | AFLAC | $33 | — | $33 | 0.08% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $19 | $11 | $30 | 0.07% |
| JASON BODKER3 Filed as: JASON D BODKER | 11230 WEST AVENUE SUITE 2209 SAN ANTONIO, TX 78213 | AFLAC | $939 | $142 | $1K | 4.10% |
| JOHN D BODKER3 | 11230 WEST AVENUE SUITE 3101 SAN ANTONIO, TX 78213 | AFLAC | $852 | — | $852 | 3.23% |
| JOHN DAVID BODKER3 Filed as: JOHN DAVID BODKER II | 11230 WEST AVENUE SUITE 3101 SAN ANTONIO, TX 78213 | AFLAC | $798 | $24 | $822 | 3.12% |
| JOHN GABRIEL JOLLY3 | 1229 N. CEDAR STREET GLENDALE, CA 91207 | AFLAC | $293 | — | $293 | 1.11% |
| TAMMY LEE LOWRIE3 | 871 ISABELL DRIVE DANDRIDGE, TN 37725 | AFLAC | $122 | — | $122 | 0.46% |
| BARBARA BAROS3 | 5301 GOSHEN COURT CORPUS CHRISTI, TX 78413 | AFLAC | $121 | — | $121 | 0.46% |
| PHILIP R CANALICHIO3 | 18315 BRACKEN DRIVE UNIT 1 GARDEN RIDGE, TX 78266 | AFLAC | $102 | — | $102 | 0.39% |
| GREGORY J WEEKS3 | 1259 LOOP 337 NORTH 2ND FLOOR NEW BRAUNFELS, TX 78130 | AFLAC | $57 | $24 | $81 | 0.31% |
| STANLEY S SCOTT3 | 355 S. MARENGO AVENUE SUITE 408 PASADENA, CA 91101 | AFLAC | $76 | — | $76 | 0.29% |
| MARSHALL CHARLES MCDONALD3 | 905 LAKE PARK DRIVE APARTMENT 206 DAVIDSON, NC 28036 | AFLAC | $70 | — | $70 | 0.27% |
| MARK LUDWICK3 Filed as: MARK D LUDWICK | 18102 BROOKWOOD FOREST SAN ANTONIO, TX 78258 | AFLAC | $53 | — | $53 | 0.20% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $40 | — | $40 | 0.15% |
| A ED GOODWIN JR3 | 520 DIXON LANE KODAK, TN 37764 | AFLAC | $35 | — | $35 | 0.13% |
| LARRY W MARONEY3 | 1230 MOUNTAIN BREEZE CANYON LAKE, TX 78133 | AFLAC | $24 | — | $24 | 0.09% |
| ABBIE W COFFMAN3 | 31 HAWTHORN CIRCLE CROSSVILLE, TN 38555 | AFLAC | $8 | — | $8 | 0.03% |
| KATHY DUFFY INSURANCE SERVICES3 | 10442 ORMOND STREET SHADOW HILLS, CA 91040 | AFLAC | $4 | — | $4 | 0.02% |
| ALAN W MARTIN3 | 123 CENTER PARK DRIVE SUITE 102 KNOXVILLE, TN 37922 | AFLAC | $1 | — | $1 | 0.00% |
| TODD V MASON3 | 6164 LAWRENCE ST CYPRESS, CA 90630 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $1K | — | $1K | 10.26% |
| SANDRA SIMS4 Filed as: SANDRA ALLEN | 501 AGUA PLACE SEAL BEACH, CA 90740 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $443 | — | $443 | 3.84% |
| MARIA SCHWARTZ4 | 312 VIA PROMESA SAN CLEMENTE, CA 92673 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $154 | — | $154 | 1.34% |
| AMY EVANS4 | 5805 SEPULVEDA BOULEVARD SUITE 740 SHERMAN OAKS, CA 91411 | PRE-PAID LEGAL SERVICES, INC. D/B/A LEGALSHIELD | $88 | — | $88 | 0.76% |
| SCOTT A HOWARD3 | 9 WHITES BRIDGE ROAD WINDHAM, ME 04062 | AFLAC | $902 | $163 | $1K | 9.36% |
| PETER D GRIFFEY3 | 139 BROAD STREET APARTMENT 6 AUBURN, ME 04210 | AFLAC | $355 | $57 | $412 | 3.62% |
| JAKE ENTERPRISES INC3 | 25 LOCKLAND DRIVE P.O. BOX 1977 WINDHAM, ME 04062 | AFLAC | $233 | $57 | $290 | 2.55% |
| WILLIAM T HENRY3 | ONE SUNDIAL AVENUE SUITE 212N MANCHESTER, NH 03103 | AFLAC | $84 | $57 | $141 | 1.24% |
| RONALD G DUNTON3 | 21 BROWN STREET LEWISTON, ME 04240 | AFLAC | $72 | — | $72 | 0.63% |
| DANIEL JOSEPH GIGUERE3 | P.O. BOX 1657 AUBURN, ME 04211 | AFLAC | $61 | — | $61 | 0.54% |
| STEPHEN W JOHNSON3 | 166 N RAYMOND ROAD GRAY, ME 04039 | AFLAC | $48 | — | $48 | 0.42% |
| ELAINE C HANSON3 | 30 CUSHNOC ROAD VASSALBORO, ME 04989 | AFLAC | $26 | — | $26 | 0.23% |
| JAMES (JAY) GRIMES3 | 6165 WATERFORD ROAD COLUMBUS, GA 31904 | AFLAC | $17 | — | $17 | 0.15% |
| BARBARA TORRES3 | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $5 | — | $5 | 0.04% |
| MAYNARD M. YOUNG3 Filed as: MAYNARD M YOUNG | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $3 | — | $3 | 0.03% |
| ROBERT P ALWARD3 | 213 RAINBOW DRIVE #11321 LIVINGSTON, TX 77399 | AFLAC | $558 | $75 | $633 | 7.10% |
| TRECIA J BRADY3 | 71 NUTMEG COURT MIDDLETOWN, CT 06457 | AFLAC | $154 | $15 | $169 | 1.89% |
| THOMAS P JEFFERY III3 | 240 CEDAR STREET NEWINGTON, CT 06111 | AFLAC | $134 | — | $134 | 1.50% |
| CHRISTIAN PISANI3 Filed as: CHRISTIAN M PISANI | 47 CRISSEY LANE SOUTHINGTON, CT 06489 | AFLAC | $96 | — | $96 | 1.08% |
| STEVEN D MARTIN3 | 58 TIMBER LANE WILLINGTON, CT 06279 | AFLAC | $76 | $15 | $91 | 1.02% |
| MICHAEL T REYES3 | 185 PLAINS ROAD SUITE 200E MILFORD, CT 06461 | AFLAC | $39 | $15 | $54 | 0.61% |
| MICHEAL G BERGER3 | 22 SUNNY RIDGE RD WAYNE, NJ 07470 | AFLAC | $32 | — | $32 | 0.36% |
| MATTHEW G BERGER3 | 1020 N DELAWARE AVENUE 4TH FLOOR PHILADELPHIA, PA 19125 | AFLAC | $7 | — | $7 | 0.08% |
| DANIEL JOSEPH GIGUERE3 | P.O. BOX 1657 AUBURN, ME 04211 | AFLAC | $274 | — | $274 | 6.09% |
| RONALD G DUNTON3 | 21 BROWN STREET LEWISTON, ME 04240 | AFLAC | $101 | — | $101 | 2.25% |
| BARBARA TORRES3 | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $75 | — | $75 | 1.67% |
| JAKE ENTERPRISES INC3 Filed as: JAKE ENTERPRIES INC | 25 LOCKLAND DRIVE P.O. BOX 1977 WINDHAM, ME 04062 | AFLAC | $58 | — | $58 | 1.29% |
| MAYNARD M. YOUNG3 Filed as: MAYNARD M YOUNG | 20 HOBBS ROAD EFFINGHAM, NH 03882 | AFLAC | $39 | — | $39 | 0.87% |
| WILLIAM T HENRY3 | ONE SUNDIAL AVE SUITE 212N MANCHESTER, NH 03103 | AFLAC | $5 | — | $5 | 0.11% |
| JOHN D BODKER3 | 11230 WEST AVENUE SUITE 3101 SAN ANTONIO, TX 78213 | AFLAC | $205 | — | $205 | 6.12% |
| JOHN DAVID BODKER3 Filed as: JOHN DAVID BODKER II | 11230 WEST AVENUE SUITE 2107 SAN ANTONIO, TX 78213 | AFLAC | $102 | — | $102 | 3.04% |
| JOHN GABRIEL JOLLY3 | 1229 N CEDAR STREET GLENDALE, CA 91207 | AFLAC | $66 | — | $66 | 1.97% |
| BARBARA BAROS3 | 5301 GOSHEN COURT CORPUS CHRISTI, TX 78413 | AFLAC | $23 | — | $23 | 0.69% |
| STANLEY S SCOTT3 | 355 S MARENGO AVENUE SUITE 408 PASADENA, CA 91101 | AFLAC | $23 | — | $23 | 0.69% |
| MARSHALL CHARLES MCDONALD3 | 905 LAKE PARK DRIVE APARTMENT 206 DADVIDSON, NC 28036 | AFLAC | $15 | — | $15 | 0.45% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $10 | — | $10 | 0.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVEUNE HARTFORD, CT 06156 | $1.3M |
| DELTA DENTAL OF ILLINOIS EIN 36-2612058 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $99K |
| AETNA BEHAVIOR HEALTH LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $22K |
| HEALTH AND HUMAN RESOURCES CENTER PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVE RSAA HARTFORD, CT 06156 | $9K |
| DEWITT STERN GROUP PLANNING SERV BROKER'S FEES | Insurance agents and brokers Service code 22 | 150 N WACKER DRIVE SUITE 2120 CHICAGO, IL 60606 | $0 |
| FOREST FINANCIAL GROUP BROKER'S FEES | Insurance agents and brokers Service code 22 | 1044 N WESTERN AVE STE G LAKE FOREST, IL 60045 | $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 | 2,920 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,987 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,125 | $6.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,873 | $246K |
| Life insurance | AETNA LIFE INSURANCE CO | 2,920 | $1.7M |
| Short-term disability(3 contracts) | AFLAC | 195 | $150K |
| Long-term disability | AETNA LIFE INSURANCE CO | 2,920 | $1.7M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,125 | $6.0M |
| Other(9 contracts, 3 carriers) | AETNA LIFE INSURANCE CO | 2,920 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,920 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.