| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | $0 | $26K | 8.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | PO BOX 748422 ATLANTA, GA 30374 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 1.93% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: CAREFIRST | 10455 MILL RUN CIR OWINGS MILLS, MD 21117 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $4K | $4K | 1.47% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 0.75% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73114 | AMERICAN FIDELITY ASSURANCE COMPANY | $8K | $0 | $8K | 6.64% |
| MADS INSURANCE AGENCY3 Filed as: MADS INS AGCY INC | 7 STATE CR SUITE 301 ANNAPOLIS, MD 21401 | AMERICAN FIDELITY ASSURANCE COMPANY | $6K | $0 | $6K | 4.93% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $779 | $4K | 6.22% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $26 | $26 | 0.04% |
| AMERICAN FIDELITY GENERAL AGENCY3 | 9000 CAMERON PARKWAY OKLAHOMA CITY, OK 73114 | EYEMED VISION CARE | $974 | $0 | $974 | 15.53% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | EYEMED VISION CARE | $264 | $0 | $264 | 4.21% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 192 | $63K |
| Vision | EYEMED VISION CARE | 79 | $6K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 247 | $127K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 247 | $127K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 94 | $296K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 247 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.