| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST FLORIDA INSURERS OF TAMPA INC3 | 3710 CORPOREX PARK DRIVE SUITE 215 TAMPA, FL 33619 | ENVISION INSURANCE COMPANY | $226K | $0 | $226K | 7.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM EIN 31-1440175 | Contract Administrator Service code 13 | — | $5.0M |
| LABORERS DISTRICT COUNCIL PENSION F EIN 31-6129964 | Contract Administrator Service code 13 | — | $1.4M |
| ENVISION PHARMACEUTICAL SERVICES EIN 05-0570789 | Contract Administrator Service code 13 | — | $494K |
| MATTHEW ARCHER EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $82K |
| BALL & TANOURY EIN 31-1165361 | Legal Service code 29 | — | $78K |
| JPMORGAN CHASE BANK N.A. EIN 38-3311528 | Investment management fees paid directly by plan Service code 51 | — | $68K |
| AMY TOY EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $54K |
| SIERRA INVESTMENTS EIN 68-0370668 | Investment management Service code 28 | — | $54K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 | Investment management fees paid directly by plan Service code 51 | — | $53K |
| CLAIM TECHNOLOGIES, INC. | Other fees Service code 99 | 100 COURT AVE #306 DES MOINES, IA 50309 | $51K |
| DENISE SIKES EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $50K |
| THE SEGAL COMPANY EIN 31-1835864 | Actuarial Service code 11 | — | $50K |
| OAKTREE CAPITAL MANAGEMENT EIN 26-2180715 | Investment management fees paid directly by plan Service code 51 | — | $46K |
| CIUNI & PANICHI EIN 34-1322309 | Accounting (including auditing) Service code 10 | — | $46K |
| JENNIFER HALL EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $46K |
| DEPARTMENT OF THE TREASURY, IRS | Other insurance fees and expenses Service code 73 | INTERNAL REVENUE SERVICE CINCINNATI, OH 459990009 | $43K |
| WILLIAM BROWN EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $43K |
| BRIAN GASTON EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $42K |
| NATIONAL VISION ADMINISTRATORS EIN 74-3033381 | Contract Administrator Service code 13 | — | $38K |
| CYNTHIA ZELLER EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $35K |
| PROFORMA EIN 31-1172026 | Copying and duplicating Service code 36 | — | $33K |
| MEKETA INVESTMENT GROUP, INC. EIN 04-2659023 | Investment advisory (plan) Service code 27 | — | $32K |
| STEVEN ZELLER EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $31K |
| TRICAST INC EIN 47-4702246 | Accounting (including auditing) Service code 10 | — | $29K |
| TRACY SWOPE EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $29K |
| NICOLE SHREVES EIN 31-6129964 EMPLOYEE | Employee (plan sponsor) Service code 35 | — | $28K |
| KRYSTAL LENDON EIN 47-5279869 | Other fees Service code 99 | — | $25K |
| PITNEY BOWES PURCHASE POWER EIN 84-1386389 | Copying and duplicating Service code 36 | — | $22K |
| MANGANO LAW OFFICES CO, LPA EIN 20-5460196 | Legal Service code 29 | — | $15K |
| BUCK CONSULTANTS EIN 13-3954297 | Actuarial Service code 11 | — | $14K |
| EMPLOYERS HEALTH COALITION, INC. EIN 34-1403820 | Insurance services Service code 23 | — | $12K |
| HEALTHY LIFE SCREENING | Other fees Service code 99 | 61 N CLEVELAND MASSILLON ROAD AKRON, OH 44333 | $11K |
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 | 11,261 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,690 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 13,951 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MONUMENTAL LIFE | 2,391 | $8.0M |
| Prescription drug | ENVISION INSURANCE COMPANY | 2,391 | $3.0M |
| Other | ENVISION INSURANCE COMPANY | 2,391 | $3.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,391 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.