| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 5310 CLARK RD STE 1 SARASOTA, FL 34233 | BLUE CROSS BLUE SHIELD OF FLORIDA | $25K | — | $25K | 3.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 951 YAMATO ROAD SUITE 200W BOCA RATON, FL 33431 | BLUE CROSS BLUE SHIELD OF FLORIDA | $2K | — | $2K | 0.34% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 STARCREST DRIVE CLEARWATER CLEARWATER, FL 33765 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $4K | $8K | 9.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 951 YAMATO RD SUITE 200W BOCA RATON, FL 33431 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $564 | — | $564 | 0.65% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE, INC | 5310 CLARK RD STE 1 SARASOTA, FL 34233 | BLUE CROSS CLUE SHIELD OF FLORIDA | $1K | — | $1K | 3.72% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 951 YAMATO ROAD SUITE 200W BOCA RATON, FL 33431 | BLUE CROSS CLUE SHIELD OF FLORIDA | $83 | — | $83 | 0.28% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $343 | — | $343 | 1.50% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE INC. | PO BOX 6090 CLEARWATER, FL 33758 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $286 | $2K | 9.58% |
| MARK F BARRETT LLC3 | 14141 46TH STREET NORTH CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $663 | $494 | $1K | 5.19% |
| SHIRLEY B DRAKE3 | 14141 64TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $541 | $379 | $920 | 4.13% |
| WORKSITE AMERICA LLC3 | 14141 46TH STREET NORTH CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $415 | $317 | $732 | 3.28% |
| HEIDI S WEISHAUPT3 | 4520 29TH AVE CIR E PALMETTO, FL 34221 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $545 | $48 | $593 | 2.66% |
| JARRET THOMAS HONAHAN3 | 7 HARBOR OAKS CIRCLE SAFETY HARBOR, FL 34695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $378 | $130 | $508 | 2.28% |
| KAREN PICCININI3 | 425 W COLONIAL DR ORLANDO, FL 32804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82 | $27 | $109 | 0.49% |
| RICHARD LEWIS SOLLNER3 Filed as: RICHARD ANTHONY CALIFANO | 3007 W SAN ISIDRO STREET TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.15% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 N STARCREST DR CLEARWATER, FL 33756 | STANDARD INSURANCE COMPANY | $534 | — | $534 | 9.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $114 | — | $114 | 2.08% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $648 | — | $648 | 12.51% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $129 | — | $129 | 2.49% |
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 | 214 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 31 | $22K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 165 | $86K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 165 | $86K |
| Life insurance | STANDARD INSURANCE COMPANY | 214 | $23K |
| Short-term disability | STANDARD INSURANCE COMPANY | 7 | $5K |
| Long-term disability | STANDARD INSURANCE COMPANY | 7 | $5K |
| Prescription drug | BLUE CROSS CLUE SHIELD OF FLORIDA | 8 | $29K |
| Other | BLUE CROSS BLUE SHIELD OF FLORIDA | 207 | $676K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.