| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBYN L PIPER3 | 12520 HIGH BLUFF DR SUITE 240 SAN DIEGO, CA 921302062 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $49K | $49K | 2.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV INC. | 2300 W SAHARA AVE SUITE 800 LAS VEGAS, NV 891024397 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $23K | $23K | 1.15% |
| PLAN SOURCE BENEFIT ADMINISTRATION3 Filed as: PLAN SOURCE BENEFITS ADMINISTRATION | 101 S GARLAND AVE SUITE 203 ORLANDO, FL 328013277 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $6K | $6K | 0.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS OF NV | PO BOX 743171 LOS ANGELES, CA 90074 | HARTFORD LIFE AND ACCIDENT | $55K | $14K | $69K | 7.12% |
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 | 2,995 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,002 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | SIMNSA | 913 | $3.7M |
| Dental(2 contracts, 2 carriers) | SIMNSA | 913 | $1.6M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,763 | $107K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 4,389 | $2.0M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 5,726 | $972K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 5,726 | $972K |
| Prescription drug(3 contracts, 2 carriers) | SIMNSA | 913 | $3.7M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 4,389 | $2.0M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 4,389 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,726 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.