| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 1133 WESTCHESTER AVE., STE N-136 WEST HARRISON, NY 10604 | ANTHEM BLUE CROSS AND BLUE SHIELD | $81K | — | $81K | 2.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 300 N BEACH ST DAYTONA BEACH, FL 32114 | ANTHEM BLUE CROSS AND BLUE SHIELD | $43K | — | $43K | 1.08% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $35K | $35K | 0.87% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE NEW YORK | 1133 WESTCHESTER AVE., STE S-229 WHITE PLAINS, NY 106043546 | SHELTERPOINT LIFE INSURANCE COMPANY | $5K | — | $5K | 6.58% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 300 N BEACH ST DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $3K | $58 | $3K | 6.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 1133 WESTCHESTER AVE., STE N-136 WEST HARRISON, NY 10604 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 5.23% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 4.95% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 11220 ASSET LOOP SUITE 104 MANASSAS, VA 20109 | STANDARD INSURANCE COMPANY | — | $573 | $573 | 1.14% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | GUARDIAN | $4K | $1K | $5K | 14.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 1133 WESTCHESTER AVE., STE N-136 WEST HARRISON, NY 10604 | ANTHEM BLUE CROSS AND BLUE SHIELD | $2K | — | $2K | 10.05% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $748 | $748 | 4.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN NONE | Plan Administrator Service code 14 | 1133 WESTCH AVE STE N136 HARRISON, NY 10604 | $36K |
| CENTERSTONE INSURANCE & FINANCIAL NONE | Insurance agents and brokers Service code 22 | 12404 PARK CTR DR S 400S DALLAS, TX 72251 | $4K |
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 | 212 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS AND BLUE SHIELD | 212 | $4.0M |
| Dental | GUARDIAN | 253 | $37K |
| Vision | GUARDIAN | 253 | $37K |
| Life insurance | ANTHEM BLUE CROSS AND BLUE SHIELD | 233 | $15K |
| Short-term disability | SHELTERPOINT LIFE INSURANCE COMPANY | 231 | $75K |
| Long-term disability | ANTHEM BLUE CROSS AND BLUE SHIELD | 233 | $15K |
| Other | SHELTERPOINT LIFE INSURANCE COMPANY | 231 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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.