| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | BLUE CROSS BLUE SHIELD OF FLORIDA | — | — | $0 | 0.00% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | HUMANA INSURANCE COMPANY | $2K | $1K | $3K | 11.94% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $275 | $2K | 22.61% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $420 | $3K | 24.03% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | HUMANA INSURANCE COMPANY | $811 | $284 | $1K | 14.30% |
| KUCHARD, PETER G3 | 7791 BELFORT PKWY JACKSONVILLE, FM 32256 | HUMANA INSURANCE COMPANY | $3 | — | $3 | 0.04% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $200 | $1K | 23.74% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $571 | $152 | $723 | 19.00% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DR S SUITE 210 SAINT AUGUSTINE, FL 32080 | ALLSTATE | $385 | — | $385 | 15.60% |
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 | 121 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 93 | $578K |
| Dental | HUMANA INSURANCE COMPANY | 79 | $29K |
| Vision | HUMANA INSURANCE COMPANY | 71 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.