| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADELISA JIMENO3 | FLORIDA BLUE 4800 DEERWOOD CAMPUS PKWY, #DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $594 | — | $594 | 0.10% |
| ADELISA JIMENO3 | FLORIDA BLUE 4800 DEERWOOD CAMPUS PKWY, #DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $140 | — | $140 | 0.12% |
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 | 321 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 321 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH OPTIONS, INC. | 273 | $2.3M |
| Dental | FLORIDA COMBINED LIFE | 209 | $118K |
| Vision | BLUE CROSS & BLUE SHIELD OF FLORIDA, INC. | 176 | $29K |
| Life insurance | FLORIDA COMBINED LIFE | 321 | $595K |
| Short-term disability | FLORIDA COMBINED LIFE | 321 | $595K |
| Long-term disability | FLORIDA COMBINED LIFE | 321 | $595K |
| Other | FLORIDA COMBINED LIFE | 321 | $595K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.