| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JLB ENTERPRISES INC3 Filed as: JLB ENTERPRISES INC DBA SLATON INS | PO BOX 220537 WEST PALM BEACH, FL 33422 | AETNA HEALTH, INC. | $34K | $0 | $34K | 5.84% |
| EXCELSIOR BENEFITS LLC3 | 4901 NW 17TH WAY SUITE 301 FORT LAUDERDALE, FL 33309 | AETNA HEALTH, INC. | $4K | $0 | $4K | 0.71% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN RD SUITE 200 EXCELSIOR, MN 55331 | AETNA HEALTH, INC. | $2K | $0 | $2K | 0.26% |
| JLB ENTERPRISES INC3 Filed as: JLB ENTERPRISES INC DBA SLATON INS | PO BOX 220537 WEST PALM BEACH, FL 33422 | AETNA LIFE INSURANCE CO. | $17K | $0 | $17K | 5.60% |
| EXCELSIOR BENEFITS LLC3 | 4901 NW 17TH WAY SUITE 301 FORT LAUDERDALE, FL 33309 | AETNA LIFE INSURANCE CO. | $2K | $0 | $2K | 0.69% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN ROAD SUITE 200 EXCELSIOR, MN 55331 | AETNA LIFE INSURANCE CO. | $742 | $0 | $742 | 0.25% |
| JLB ENTERPRISES INC3 | 5713 CORPORATE WAY SUITE 200 WEST PALM BEACH, FL 33407 | HUMANA INSURANCE COMPANY | $5K | $61 | $5K | 6.84% |
| JLB ENTERPRISES INC3 | 5713 CORPORATE WAY SUITE 200 WEST PALM BEACH, FL 33407 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 121 | $877K |
| Dental | HUMANA INSURANCE COMPANY | 190 | $69K |
| Vision | HUMANA INSURANCE COMPANY | 190 | $69K |
| Life insurance | HUMANA INSURANCE COMPANY | 190 | $69K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 200 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.