| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $76K | $76K | 3.91% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | — | $22K | 12.00% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 Filed as: UNITED BENEFIT ADVISORS OF FL LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 9.95% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 5.90% |
| REEVES TRACY3 Filed as: REEVES, TRACY | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 11.20% |
| DEVAUX, MIKE3 | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $564 | — | $564 | 4.18% |
| WILLIAMS GAVIN3 Filed as: WILLIAMS, GAVIN | 8130 BAUTISTA WAY PALM BEACH GARDENS, FL 33418 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $219 | — | $219 | 1.62% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $162 | — | $162 | 1.20% |
| AMERICAN INS PLUS LLC | 8143 BAUTISTA WAY PALM BEACH GARDENS, FL 33418 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $117 | — | $117 | 0.87% |
| TRACY L REEVES3 | 16273 SW 9TH STREET PEMBROKE PINES, FL 32401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 14.00% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 Filed as: UNITED BENEFIT ADVISORS OF FL LLC | 560 HARRISON AVENUE PANAMA CITY, FL 32401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $623 | $137 | $760 | 7.32% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE STE 210 JACKSONVILLE, FL 32216 | MUTUAL OF OMAHA INSURANCE COMPANY | $683 | — | $683 | 12.00% |
| TRACY REEVES4 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $317 | — | $317 | 5.63% |
| STEVE BAKER4 | 153 ESTHER DR COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $139 | — | $139 | 2.47% |
| BARRY OLFERN AND ASSOC. INC4 | 954 TYLER ST HOLLYWOOD, FL 33019 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $103 | — | $103 | 1.83% |
| UNIQUE BENEFITS GROUP INC4 | 7 CAPOZZI CIR WOBURN, MA 01801 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $22 | — | $22 | 0.39% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 210 | $1.9M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 164 | $121K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 343 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $179K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $179K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $179K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 210 | $1.9M |
| Other(5 contracts, 5 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 197 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 343 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.