| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLMENT ALLIANCE LLC3 | 3030 N ROCKY POINT DR STE 150 TAMPA, FL 33607 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $4K | — | $4K | 5.31% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.43% |
| JAHNOL EVANS | 9303 ASHFIELD CT TAMPA, FL 33615 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $1K | — | $1K | 1.64% |
| JAKE ZIMMERMAN3 | 6302 NESTING CT TAMPA, FL 33625 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $746 | — | $746 | 1.06% |
| JEFFREY NELSON3 | 8512 WESTERLAND DR LAND O LAKES, FL 34637 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $520 | — | $520 | 0.74% |
| KATHLEEN ANN NELSON3 Filed as: KATHLEEN NELSON | 8512 WESTERLAND DR LAND O LAKES, FL 34637 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $241 | — | $241 | 0.34% |
| JENNA L CARLONE3 Filed as: JENNA CARLONE | 573 SCRUBJAY LANE JUPITER, FL 33458 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $101 | — | $101 | 0.14% |
| ENRIQUE INGLESIAS3 | 1706 BELLEAIR FOREST DR #252 BELLEAIR, FL 33756 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $95 | — | $95 | 0.13% |
| CRISTINA M FIALLO3 Filed as: CRISTINA FIALLO | 18102 PORTSIDE ST TAMPA, FL 33647 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $84 | — | $84 | 0.12% |
| ROBERT LEESMAN3 | 7933 HAMPTON LAKE DRIVE TAMPA, FL 33647 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $76 | — | $76 | 0.11% |
| BENEFITS WITH FRIENDS3 Filed as: BENEFITS WITH FRIENDS LLC | 9113 79TH AVE SEMINOLE, FL 33777 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $67 | — | $67 | 0.10% |
| VICTORRIO PAUL ZANIOL INC3 Filed as: VICTORRIO PAUL ZANIOL INC. | 7301 6TH AVE N ST. PETERSBURG, FL 33710 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $49 | — | $49 | 0.07% |
| K & J NELSON INC3 | 8512 WESTERLAND DR LAND O LAKES, FL 34637 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $32 | — | $32 | 0.05% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 20.39% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 20.84% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 10.54% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | RELIANCE STANDARD LIFE INSURANCE CO | $2K | — | $2K | 12.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | — | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.06% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $272 | — | $272 | 1.94% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | RELIANCE STANDARD LIFE INSURANCE CO | $796 | — | $796 | 12.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $64K |
| ROGER BROUCHARD INS INC EIN 59-1117778 BROKER | Other commissions Service code 55 | 101 STARCREST DR CLEARWATER, FL 33765 | $33K |
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 | 568 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 568 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $758K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $54K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 237 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 140 | $54K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | 568 | $126K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $728K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 568 | — |
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."
No prospect flags tripped on this filing.