| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | BLUE CROSS BLUE SHIELD OF FLORIDA | $50K | $0 | $50K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $972 | $9K | 10.22% |
| DONNA GRIBBEN CARRILLO3 | 130 WHITAKER RD STE A LUTZ, FL 33549 | NORTHWESTERN MUTUAL | $4K | $1K | $5K | 8.18% |
| THERESA STONER ANNUNZIATA3 | 700 CENTRAL AVE STE 300 ST. PETERSBURG, FL 33701 | NORTHWESTERN MUTUAL | $1K | $346 | $2K | 2.73% |
| KACEE ELIZABETH HOWES3 | AND VARIOUS OTHER BROKERS 700 CENTRAL AVE STE 300 ST PETERSBURG, FL 33701 | NORTHWESTERN MUTUAL | $1K | $263 | $1K | 2.16% |
| DONNA GRIBBEN CARRILLO3 | 130 WHITAKER RD STE A LUTZ, FL 33549 | NORTHWESTERN MUTUAL | $2K | $506 | $3K | 7.71% |
| THERESA STONER ANNUNZIATA3 | 700 CENTAL AVE STE 300 ST PETERSBURG, FL 33701 | NORTHWESTERN MUTUAL | $670 | $169 | $839 | 2.57% |
| KACEE ELIZABETH HOWES3 | AND OTHER VARIOUS BROKERS 700 CENTAL AVE STE 300 ST PETERSBURG, FL 33701 | NORTHWESTERN MUTUAL | $536 | $128 | $664 | 2.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | USABLE LIFE | $600 | $592 | $1K | 6.71% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $839 | $338 | $1K | 6.62% |
| WILLIAM E GECEWICZ3 | AND VARIOUS OTHER BROKERS 11113 LAKESIDE VISTA DR RIVERVIEW, FL 33569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $927 | $61 | $988 | 12.83% |
| RONALD SADOFSKY3 | 14887 SEA MYRTLE LN HUDSON, FL 34667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.18% |
| CHRISTINA BIEBER3 | 12827 WOODMILL DR PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | USABLE LIFE | $144 | $110 | $254 | 7.23% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $166 | $64 | $230 | 6.55% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | USABLE LIFE | $97 | $96 | $193 | 6.70% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY #DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $136 | $55 | $191 | 6.63% |
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 | 105 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 120 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 231 | $85K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 231 | $85K |
| Life insurance(2 contracts) | USABLE LIFE | 105 | $21K |
| Short-term disability | NORTHWESTERN MUTUAL | 77 | $33K |
| Long-term disability | NORTHWESTERN MUTUAL | 76 | $63K |
| Other(2 contracts) | USABLE LIFE | 105 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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."
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.