| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | UNUM LIFE INSURANCE CONPANY OF AMERICA | $25K | $2K | $27K | 12.32% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | DENTAQUEST MID-ATLANTIC, INC. | $14K | — | $14K | 6.41% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $98 | $2K | 18.51% |
| INSURANCE OFFICE OF AMERICA ONTARIO3 Filed as: INSURANCE OFFICE OF AMERICA - TAMPA | 1855 W STATE RD 434 LONGWOOD, FL 32750 | ADVANTICA REINSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUE CROSS BLUE SHIELD EIN 53-0078070 HLTH PROVIDER | Other commissions; Float revenue; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $864K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 STD ASO PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $18K |
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 | 400 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTAQUEST MID-ATLANTIC, INC. | 629 | $215K |
| Vision | ADVANTICA REINSURANCE COMPANY | 163 | $10K |
| Life insurance | UNUM LIFE INSURANCE CONPANY OF AMERICA | 417 | $216K |
| Long-term disability | UNUM LIFE INSURANCE CONPANY OF AMERICA | 417 | $216K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE CONPANY OF AMERICA | 417 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 629 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.