| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.12% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| PINEYWOODS BENEFITS AGENCY LLC3 Filed as: PINEYWOODS BENEFITS AGENCY, LLC | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $852 | — | $852 | 10.00% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $866 | — | $866 | 15.01% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $811 | — | $811 | 14.99% |
| ENROLLMENT ALLIANCE LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $270 | $270 | 4.99% |
| PINEYWOODS BENEFITS AGENCY LLC3 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $530 | — | $530 | 14.99% |
| ENROLLMENT ALLIANCE LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $177 | $177 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CLAIMS PROCESSING | Insurance services; Claims processing Service code 12 | — | $35K |
| PINEYWOODS BENEFITS AGENCY, LLC BROKER | Insurance agents and brokers Service code 22 | 2023 W PLATT ST STE 224 TAMPA, FL 33606 | $14K |
| CIGNA | Float revenue; Named fiduciary; Participant communication; Claims processing; Contract Administrator; Direct payment from the plan; Other services; Non-monetary compensation Service code 12 | — | $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 | 119 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $48K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 76 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $6K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 97 | $222K |
| Other(6 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.