| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INS & PAYROLL RESOURCE3 Filed as: THE INS & PAYROLL RES GRP OF FL | 1101 N. LAKE DESTINY ROAD, STE 100 MAITLAND, FL 327517112 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $33K | $0 | $33K | 13.22% |
| ROGERS BENEFIT GROUP INC3 | — | CIGNA HEALTH & LIFE INSURANCE COMPANY | $0 | $11K | $11K | 4.41% |
| THE INS & PAYROLL RESOURCE3 Filed as: INS & PAYROLL RES GRP OF FL | 1101 N. LAKE DESTINY RD, STE 100 MAITLAND, FL 327517112 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $4K | $21K | 15.83% |
| VIRMELIA RODRIGUEZ3 | 10090 BENNINGTON CHASE DR. ORLANDO, FL 32829 | AFLAC | $1K | $215 | $1K | 5.49% |
| A & M BONURA & ASSOCIATES INC3 Filed as: A&M BONURA & ASSOCIATES | 1882 LAUREL BROOK LOOP CASSELBERRY, FL 32707 | AFLAC | $635 | $65 | $700 | 3.15% |
| CINDY DEBRA WEISS3 Filed as: CINDY WEISS | PO BOX 149505 ORLANDO, FL 32814 | AFLAC | $171 | $65 | $236 | 1.06% |
| A & M HARNER & ASSOCIATES LLC3 Filed as: A & M HARNER & ASSOC, LLC | 101 COLYER DR LONGWOOD, FL 32779 | AFLAC | $130 | $22 | $152 | 0.68% |
| JOHN F DUSSLING3 Filed as: JOHN F. DUSSLING | 2009 TULLAGEE AVE. MELBOURNE, FL 32940 | AFLAC | $139 | $0 | $139 | 0.63% |
| JOYCE WEBER ENTERPRISES INC3 | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $52 | $0 | $52 | 0.23% |
| TEAM WEISS AND ASSOC LLC3 Filed as: TEAM WEISS AND ASSOC. LLC | P.O. BOX 149505 ORLANDO, FL 32814 | AFLAC | $49 | $0 | $49 | 0.22% |
| A & M HARNER & ASSOCIATES LLC3 | 102 N SWEETWATER BLVD. LONGWOOD, FL 32779 | AFLAC | $17 | $0 | $17 | 0.08% |
| MKF & ASSOCIATES INC3 | 4222 MARDEN WAY VESTAVIA, AL 35242 | AFLAC | $15 | $0 | $15 | 0.07% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | AFLAC | $8 | $0 | $8 | 0.04% |
| PATRICIA ANNE REILLY3 Filed as: PATRICIA REILLY | 269 E LONG CREEK CV LONGWOOD, FL 32750 | AFLAC | $8 | $0 | $8 | 0.04% |
| DOUGLAS J SUCHECKI3 Filed as: DOUGLAS SUCHECKI | 21 HEARTWOOD DR CATAULA, GA 31804 | AFLAC | $3 | $0 | $3 | 0.01% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHECKI | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $3 | $0 | $3 | 0.01% |
| CLARISSA LYNNE HERRICK3 Filed as: CLARISSA HERRICK | 2791 HAPPY HOLLOW RD SEVIERVILLE, TN 37862 | AFLAC | $3 | $0 | $3 | 0.01% |
| DEREK DEVANE3 | 3205 JERRY SMITH RD DOVER, FL 33527 | AFLAC | $1 | $0 | $1 | 0.00% |
| BRIAN WHITE3 Filed as: BRIAN HANLEY | 1862 KEYSTONE PL SCHAUMBURG, IL 60193 | AFLAC | $1 | $0 | $1 | 0.00% |
| SARAH CADY3 | 123 STONE GABLE CIR WINTER SPRINGS, FL 32708 | AFLAC | $0 | $0 | $0 | 0.00% |
| JENNIE HAWKINS3 | 4215 S RIDGEWOOD AVE STE 104 PORT ORANGE, FL 32127 | AFLAC | $0 | $0 | $0 | 0.00% |
| THE INS & PAYROLL RESOURCE3 Filed as: INS & PAYROLL RES GRP OF FL | 1101 N. LAKE DESTINY RD., STE 100 US MAITLAND, FL 327517112 | TELEDOC | $321 | $0 | $321 | 14.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Non-monetary compensation; Claims processing; Contract Administrator; Named fiduciary; Float revenue; Participant communication; Other services; Direct payment from the plan Service code 12 | — | $4K |
| TELEDOC EIN 04-3705970 SERVICE PROVIDER | Other insurance fees and expenses Service code 73 | 1945 LAKEPOINTE DR LEWISVILLE, TX 75057 | $2K |
| MEDCOM BENEFIT SOLUTIONS EIN 59-2316866 SERVICE PROVIDER | Other fees Service code 99 | P.O. BOX 10269 JACKSONVILLE, FL 322470269 | $659 |
| CIGNA | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
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 | 261 | 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) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 57 | $255K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $131K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $131K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $131K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $131K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 329 | $131K |
| Other | AFLAC | 16 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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.