| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMBINED INSURANCE SERVICES3 Filed as: COMBINED INS. SERVICES OF N. FL. | 1403 E BELMONT ST PENSACOLA, FL 32501 | BLUE CROSS BLUE SHIELD OF FL | $35K | — | $35K | 2.50% |
| COMBINED INSURANCE SERVICES3 Filed as: COMBINED INS. SERVICES OF N. FL. | 1403 E BELMONT ST. PENSACOLA, FL 32501 | HEALTH OPTIONS, INC. | $12K | — | $12K | 2.50% |
| COMBINED INSURANCE SERVICES3 Filed as: COMBINED INS. SERVICES OF N. FL | 1403 E BELMONT ST PENSACOLA, FL 32501 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $7K | $19K | 14.90% |
| COMBINED INSURANCE SERVICES3 Filed as: COMBINED INS. SERVICES OF N. FL. | 1403 E BELMONT ST PENSACOLA, FL 32501 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.01% |
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 | 201 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FL | 143 | $1.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 187 | $126K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 10 | $7K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FL | 143 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.