| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EXCALIBUR FINANCIAL GROUP3 | 302 KNIGHTS RUN #110 TAMPA, FL 33602 | BLUE CROSS AND BLUE SHIELD OF FLORIDA | $71K | $0 | $71K | 5.00% |
| EXCALIBUR FINANCIAL GROUP3 | 302 KNIGHTS RUN #110 TAMPA, FL 33602 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 26.22% |
| EXCALIBUR FINANCIAL GROUP3 | 302 KNIGHTS RUN #110 TAMPA, FL 33602 | FLORIDA COMBINED LIFE | — | $3K | $3K | 5.73% |
| FLORIDA PREFERRED ADMINISTRATORS, I3 | 600 CATTLERIDGE DR SUITE 302 SARASOTA, FL 34232 | FLORIDA COMBINED LIFE | — | $271 | $271 | 0.47% |
| EXCALIBUR FINANCIAL GROUP3 | 302 KNIGHTS RUN #110 TAMPA, FL 33602 | FLORIDA BLUE | $1K | $0 | $1K | 9.58% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF FLORIDA | 155 | $1.4M |
| Dental | FLORIDA COMBINED LIFE | 119 | $57K |
| Vision | FLORIDA BLUE | 89 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $78K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $78K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $78K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF FLORIDA | 155 | $1.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 161 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.