| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF FLORIDA | $58K | — | $58K | 3.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | FLORIDA COMBINED LIFE | $10K | — | $10K | 9.84% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N MARTINGALE R., STE 100 SCHAUMBURG, IL 60173 | USABLE LIFE | $10K | — | $10K | 10.84% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF FL | 4800 DEERWOOD CAMPUS PKWY, STE DC22 JACKSONVILLE, FL 32246 | USABLE LIFE | $1K | — | $1K | 1.16% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD, STE 100 SCHAUMBURG, IL 60173 | UNITEDHEALTHCARE INSURANCE CO | $2K | — | $2K | 8.56% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITEDHEALTHCARE INSURANCE CO | $322 | — | $322 | 1.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S. WACKER DR., STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE CO | $786 | $151 | $937 | 13.64% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $354 | $54 | $408 | 5.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO | 775 YARD ST, STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE CO | — | $47 | $47 | 0.68% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 200 | $1.9M |
| Dental | FLORIDA COMBINED LIFE | 152 | $105K |
| Vision | UNITEDHEALTHCARE INSURANCE CO | 325 | $22K |
| Life insurance | USABLE LIFE | 283 | $90K |
| Short-term disability | USABLE LIFE | 283 | $90K |
| Long-term disability | USABLE LIFE | 283 | $90K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 200 | $1.9M |
| Other(3 contracts, 3 carriers) | USABLE LIFE | 305 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 325 | — |
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.