| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | METROPOLITAN LIFE INSURANCE COMPANY | $44K | $43 | $44K | 12.14% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 1.87% |
| BENETEK CORPORATION3 | 6277 SEA HARBOR DR ORLANDO, FL 32821 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.81% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | TRUSTMARK INSURANCE COMPANY | $3K | — | $3K | 5.15% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 2.47% |
| BRIAN D ELY3 | 2121 NEWMARKEY PRKWY SE- SUITE 100 MARIETTA, GA 30067 | TRUSTMARK INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 9.36% |
| VBW INSURANCE SERVICES, INC3 Filed as: VBW INSURANCE SERVICES, INC. | 3000 WINDY HILL RD - SUITE 672617 MARIETTA, GA 30067 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 5.47% |
| BRIAN D ELY3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.83% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | TRUSTMARK INSURANCE COMPANY | $5K | — | $5K | 9.33% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 3.04% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE. ROAD 434 LONGWOOD, FL 32750 | TRUSTMARK INSURANCE COMPANY | $6K | — | $6K | 13.34% |
| VOLUNTARY BENEFITS AT WORK3 | 1820 THE EXCHANGE SE - SUITE 750 ATLANTA, GA 30339 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 4.42% |
| BRIAN D ELY3 | 2121 NEWMARKEY PRKWY SE- SUITE 100 MARIETTA, GA 30067 | TRUSTMARK INSURANCE COMPANY | $18 | — | $18 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTHCARE EIN 58-1638390 | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services Service code 12 | — | $375K |
| LUMINARE HEALTH BENEFITS, INC. EIN 35-1846036 | Claims processing; Plan Administrator; Other services Service code 12 | — | $108K |
| ANTHEM EIN 95-4331852 | Other services; Claims processing Service code 12 | — | $93K |
| INSURANCE OFFICE OF AMERICA INC EIN 59-2472656 | Consulting (general); Insurance agents and brokers Service code 16 | — | $50K |
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 | 317 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 81 | $97K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $363K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $363K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $414K |
| Short-term disability | TRUSTMARK INSURANCE COMPANY | 104 | $52K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $363K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $363K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 839 | — |
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.