| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DR SUITE 101 PONTE VERDE BEACH, FL 32082 | GEISINGER QUALITY OPTIONS, INC | $19K | $0 | $19K | 3.00% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $5K | $924 | $6K | 14.22% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 11.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 13.77% |
| JOSEPH B MCGINTY JR3 Filed as: JOSEPH B. MCGINTY JR | 1607 NICOLA CROSSWAY WILLIAMSPORT, PA 17701 | AFLAC | $956 | $0 | $956 | — |
| WANDA J. FORT3 | 6751 CABELLO DR JACKSONVILLE, FL 32226 | AFLAC | $650 | $0 | $650 | — |
| JEFFREY CHUBB3 | 520 W FOURTH STREET STE 1A WILLIAMSPORT, PA 17701 | AFLAC | $383 | $0 | $383 | — |
| CHRIS GUZEWICH3 | 1007 DRAKEFEATHER DR ORANGE PARK, FL 32065 | AFLAC | $260 | $0 | $260 | — |
| MATTHEW JAMES SLOAN3 | 1100 CEDAR ST NEPTUNE BEACH, FL 32266 | AFLAC | $221 | $0 | $221 | — |
| THOMAS JAMES OLLER3 | 1488 MARSH RABBIT WAY FLEMING ISLAND, FL 32003 | AFLAC | $147 | $0 | $147 | — |
| BETH LUANNE KIMBROUGH3 | 6750 N ANDREWS AVE SUITE 200 FT LAUDERDALE, FL 33309 | AFLAC | $35 | $0 | $35 | — |
| JAMEY MILLER INC3 | 4811 BEACH BLVD SUITE 107 JACKSONVILLE, FL 32207 | AFLAC | $30 | $0 | $30 | — |
| TROY DANIEL DESLATTE3 | 107 SHADY PARK DRIVE LAFAYETTE, LA 70508 | AFLAC | $30 | $0 | $30 | — |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE ROAD PHILADELPHIA, PA 19125 | AFLAC | $22 | $0 | $22 | — |
| TRACI R BATTEN3 | 144 BRIDGEPORT CT ROCKY MOUNT, NC 27804 | AFLAC | $19 | $0 | $19 | — |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK SUITE 101 PONTE VEDRA BEACH, FL 32082 | AFLAC | $16 | $0 | $16 | — |
| SHADEL & ASSOCIATES LLC3 | 4811 BEACH BLVD SUITE 107 JACKSONVILLE, FL 32207 | AFLAC | $7 | $0 | $7 | — |
| MG BERGER INC3 Filed as: MG BERGER, INC | 1020 N DELAWARE AVE SUITE 4 PHILADELPHIA, PA 19125 | AFLAC | $1 | $0 | $1 | — |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GEISINGER QUALITY OPTIONS, INC | 93 | $625K |
| Dental | UNION SECURITY INSURANCE COMPANY | 79 | $40K |
| Vision | UNION SECURITY INSURANCE COMPANY | 79 | $40K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 209 | $33K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 209 | $33K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 209 | $33K |
| Prescription drug | GEISINGER QUALITY OPTIONS, INC | 93 | $625K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 209 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.