| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE AMERICA | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | $7K | $42K | 21.00% |
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 9.89% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 2.60% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $916 | $916 | 7.20% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $472 | $472 | 3.96% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 14.99% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $663 | $663 | 7.53% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $360 | $360 | 4.71% |
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $650 | — | $650 | 10.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $689 | — | $689 | 15.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $338 | $338 | 7.36% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $240 | — | $240 | 15.03% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $118 | $118 | 7.39% |
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA DENTAL HEALTH OF TEXAS, INC. | $116 | — | $116 | 9.97% |
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA DENTAL HEALTH OF KANSAS, INC. | $58 | — | $58 | 9.98% |
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FL 33411 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $26 | — | $26 | 10.08% |
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 | 80 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 81 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $199K |
| Dental(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 60 | $53K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 60 | $45K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $10K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $5K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $199K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 80 | — |
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.