| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 | 8191 COLLEGE PKWY #202 FORT MYERS, FL 33919 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $12K | $12K | 2.04% |
| ROGER BOUCHARD INSURANCE INC3 | P.O. BOX 6090 CLEARWATER, FL 33758 | UNITED HEALTHCARE INSURANCE COMPANY | $13K | — | $13K | 10.12% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $8K | $25K | 22.42% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 4.94% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $7K | $22K | 21.58% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 4.38% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | RELIANCE STANDARD LIFE INSURANCE CO | $7K | — | $7K | 12.50% |
| HOWARD LABOW3 | 666 DUNDEE RD # 1603 NORTHBROOK, IL 60062 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 6.65% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 4.14% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | RELIANCE STANDARD LIFE INSURANCE CO | $3K | — | $3K | 12.50% |
| ROGER BOUCHARD INSURANCE INC3 | P.O. BOX 6090 CLEARWATER, FL 33758 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 | Claims processing Service code 12 | — | $186K |
| ROGER BOUCHARD INSURANCE | Other commissions Service code 55 | PO BOX 6090 CLEARWATER, FL 33758 | $60K |
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 | 593 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 593 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 310 | $594K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 371 | $128K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 476 | $23K |
| Life insurance(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 276 | $206K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 593 | $159K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 310 | $594K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 593 | — |
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.