| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MINNESOTA, INC. | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $59K | $257 | $59K | 2.37% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $24K | $257 | $24K | 0.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | MEDICA INSURANCE COMPANY | $8K | $257 | $9K | 0.35% |
| HAYS COMPANIES, INC.3 | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | AMERITAS LIFE INSURANCE CORPORATION | $10K | $0 | $10K | 6.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF CALIFORNIA, INC. | 1350 OLD BAYSHORE HIGHWAY SUITE 910 BURLINGAME, CA 94010 | AMERITAS LIFE INSURANCE CORPORATION | $5K | $0 | $5K | 3.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF MISSOURI, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MO 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $0 | $14K | 13.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $640 | $640 | 0.65% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF VIRGINIA, INC. | 11220 ASSET LOOP, SUITE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $496 | $496 | 0.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF GEORGIA, INC. | PO BOX 749140 ATLANTA, GA 30374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $378 | $51 | $429 | 15.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $41 | $0 | $41 | 1.47% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 320 | $2.5M |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 305 | $145K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 304 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $98K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $98K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $98K |
| Prescription drug | MEDICA INSURANCE COMPANY | 320 | $2.5M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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."
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.