| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | UNITEDHEALTHCARE INSURANCE COMPANY | $59K | — | $59K | 5.91% |
| ROGER BOUCHARD INSURANCE INC3 | 8191 COLLEGE PKWY STE 202 FORT MYERS, FL 33919 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | $1K | $12K | 16.77% |
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.12% |
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GROUP INC | 302 KNIGHTS RUN STE 110 TAMPA, FL 33602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 4.17% |
| YOLANDA TRISTANCHO-HELWIG3 | 449 CENTRAL AVE ST. PETERSBURG, FL 33701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 1.51% |
| ANDREA BROWNING3 | 145 19TH AVE SE ST. PETERSBURG, FL 33705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.58% |
| ANDERSON BENEFIT SOLUTIONS3 | 3821 LAKE PADGETT DR LAND O LAKES, FL 34639 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.23% |
| STEVEN VERMETTE INC3 | 920 SPRING PARK LOOP CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.17% |
| THOMAS WALLACE JR3 | 57 WYN OAK DR NASHVILLE, TN 37205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.06% |
| CHOICE BENEFIT SOLUTIONS INC3 Filed as: CHOICE BENEFIT SOLUTIONS | 525 CAPRI BLVD TREASURE ISLAND, FL 33706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.06% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 267 | $1.0M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 267 | $1.0M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 188 | $15K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $69K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $69K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $69K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.