| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $28K | — | $28K | 8.09% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 Filed as: UNITED BENEFIT ADVISORS OF FL LLC | 560 HARRISON AVENUE PANAMA CITY, FL 32401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $6K | 13.12% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $222 | $3K | 11.84% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $103 | $2K | 17.14% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 Filed as: UNITED BENEFIT ADVISORS OF FL LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 18.59% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $813 | $61 | $874 | 11.41% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS INC | 280 E 96TH STREET STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $343K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $49K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $52K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $47K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $39K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 102 | $343K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $52K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.