| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | HEALTH OPTIONS, INC. | $25K | $0 | $25K | 4.39% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SERVICES, | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | BLUE CROSS BLUE SHIELD OF FLORIDA | $5K | $0 | $5K | 4.11% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | AETNA LIFE INSURANCE CO. | $485 | $0 | $485 | 1.06% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 2056 VISTA PKWY SUITE 305 WEST PALM BEACH, FL 33411 | AETNA LIFE INSURANCE CO. | $390 | $0 | $390 | 0.85% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | USABLE LIFE | $710 | $0 | $710 | 12.01% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $52 | $0 | $52 | 0.88% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | USABLE LIFE | $855 | $0 | $855 | 14.99% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $51 | $0 | $51 | 0.89% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | USABLE LIFE | $475 | $0 | $475 | 14.98% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $28 | $0 | $28 | 0.88% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 81 | $707K |
| Dental | AETNA LIFE INSURANCE CO. | 151 | $46K |
| Vision | AETNA LIFE INSURANCE CO. | 151 | $46K |
| Life insurance(2 contracts) | USABLE LIFE | 174 | $12K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS, INC. | 81 | $707K |
| Other(3 contracts) | USABLE LIFE | 174 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.