| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1715 NORTH WEST SHORE BOULEVARD SUITE 700 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $44K | $0 | $44K | 4.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | $0 | $23K | 11.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $9K | $9K | 4.59% |
| USI INSURANCE SERVICES LLC3 | 1715 NORTH WEST SHORE BOULEVARD SUITE 700 TAMPA, FL 33607 | HEALTH OPTIONS | $8K | $0 | $8K | 5.00% |
| SHIRLEY B DRAKE3 Filed as: SHIRLEY B. DRIAKW | 14141 46TH STREET NORTH, SUITE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $479 | $58 | $537 | 5.43% |
| DANA BRETT POLK3 | 10801 STARKEY ROAD, SUITE 104-321 SEMINOLE, FL 33777 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $318 | $0 | $318 | 3.22% |
| SHELBY GROUP INC3 Filed as: SHELBY GROUP, INC. | 1009 PARK DRIVE DUNEDIN, FL 34698 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $215 | $24 | $239 | 2.42% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE AMERICA, LLC | 14141 46TH STREET NORTH, SUITE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | $38 | $175 | 1.77% |
| PATRICIA M CARDUCCI3 Filed as: PATRICIA M. CARDUCCI | 4784 SIMCOE STREET PALM HARBOR, FL 34683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | $27 | $98 | 0.99% |
| STEPHANIE SHEPPA3 Filed as: STEPHANIE SHEPPA AND OTHER AGENTS | 3687 IMPERIAL RIDGE PARKWAY PALM HARBOR, FL 34684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $0 | $55 | 0.56% |
| WALTER H MODARELLI3 Filed as: WALTER H. MODARELLI | 11502 CARROLLWOOD DRIVE TAMPA, FL 33618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | $0 | $34 | 0.34% |
| JOSH SIMMS3 | 2502 NORTH ROCKY POINT ROAD SUITE 400 TAMPA, FL 33607 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 12.00% |
| THE LOOMIS COMPANY5 | 850 NORTH PARK AVENUE WYOMISSING, PA 19610 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $787 | $0 | $787 | 9.00% |
| ALLSTATE BENEFITS3 | 1776 AMERICAN HERITAGE LIFE DRIVE JACKSONVILLE, FL 32224 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $700 | $0 | $700 | 8.00% |
| KELLEY J RHEAULT4 Filed as: KELLEY J. RHEAULT | 155 CONCHA DRIVE SEBASTIAN, FL 32958 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $182 | $0 | $182 | 5.88% |
| USI INSURANCE SERVICES LLC4 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $44 | $0 | $44 | 1.42% |
| DIGITAL INSURANCE LLC4 Filed as: DIGITAL INSURANCE | 200 GALLERIA PARKWAY SE, SUITE 1950 ATLANTA, GA 30339 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $40 | — | $40 | 1.29% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 77 | $1.2M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $193K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $193K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $203K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $193K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $193K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 77 | $1.2M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 103 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.