| 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 | $23K | $0 | $23K | 3.00% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $5K | $1K | $6K | 11.83% |
| JOSEPH B MCGINTY JR3 Filed as: JOSEPH B. MCGINTY JR | 1607 NICOLA CROSSWAY WILLIAMSPORT, PA 17701 | AFLAC | $1K | $9 | $1K | 5.78% |
| WANDA J. FORT3 | 6751 CABELLO DR JACKSONVILLE, FL 32226 | AFLAC | $606 | $5 | $611 | 3.34% |
| JEFFREY CHUBB3 | 520 W FOURTH STREET STE 1A WILLIAMSPORT, PA 17701 | AFLAC | $380 | $2 | $382 | 2.09% |
| CHRIS GUZEWICH3 | 1007 DRAKEFEATHER DR ORANGE PARK, FL 32065 | AFLAC | $231 | $0 | $231 | 1.26% |
| MATTHEW JAMES SLOAN3 | 1100 CEDAR ST NEPTUNE BEACH, FL 32266 | AFLAC | $185 | $0 | $185 | 1.01% |
| THOMAS JAMES OLLER3 | 1488 MARSH RABBIT WAY FLEMING ISLAND, FL 32003 | AFLAC | $130 | $0 | $130 | 0.71% |
| BETH LUANNE KIMBROUGH3 | 6750 N ANDREWS AVE SUITE 200 FT LAUDERDALE, FL 33309 | AFLAC | $30 | $0 | $30 | 0.16% |
| TROY DANIEL DESLATTE3 | 107 SHADY PARK DRIVE LAFAYETTE, LA 70508 | AFLAC | $26 | $0 | $26 | 0.14% |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE ROAD PHILADELPHIA, PA 19125 | AFLAC | $18 | $0 | $18 | 0.10% |
| JIMMY LEON JOHNSON3 | 28 MAGNOLIA AVE ST AUGUSTINE, FL 32084 | AFLAC | $8 | $0 | $8 | 0.04% |
| JAMES R MIRABELLI3 | 99 SW MIZNER BLVD APT 843 BOCA RATON, FL 33432 | AFLAC | $5 | $0 | $5 | 0.03% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $5 | $0 | $5 | 0.03% |
| DARREN D RIDDLE3 | 7850 AVONDALE TERREACE HARRISBURG, PA 17112 | AFLAC | $5 | $0 | $5 | 0.03% |
| RYAN K GOLDBERG3 | 103 CHURCH STREET #3 PHILADELPHIA, PA 19106 | AFLAC | $5 | $0 | $5 | 0.03% |
| JAMEY MILLER INC3 | 4811 BEACH BLVD SUITE 107 JACKSONVILLE, FL 32207 | AFLAC | $3 | $0 | $3 | 0.02% |
| MARTIN E BYSTROM3 | 333 OVERLOOK LANE GULPH MILLS, PA 19428 | AFLAC | $3 | $0 | $3 | 0.02% |
| TRACI R BATTEN3 | 144 BRIDGEPORT CT ROCKY MOUNT, NC 27804 | AFLAC | $2 | $0 | $2 | 0.01% |
| MICHELLE HASKELL3 | P.O. BOX 440307 JACKSONVILLE, FL 32222 | AFLAC | $1 | $0 | $1 | 0.01% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES, LLC | 4233 PABLO PROFESSIONAL COURT SUITE 200 JACKSONVILLE, FL 32224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 10.15% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES, LLC | 4233 PABLO PROFESSIONAL COURT SUITE 200 JACKSONVILLE, FL 32224 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 15.29% |
| 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 | 14.98% |
| 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 | $754 | $0 | $754 | 10.12% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GEISINGER QUALITY OPTIONS, INC | 95 | $766K |
| Dental | UNION SECURITY INSURANCE COMPANY | 87 | $54K |
| Vision | UNION SECURITY INSURANCE COMPANY | 87 | $54K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 121 | $7K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 46 | $14K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 32 | $13K |
| Prescription drug | GEISINGER QUALITY OPTIONS, INC | 95 | $766K |
| Other(3 contracts, 2 carriers) | AFLAC | 121 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.