| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | SUN LIFE ASSURANCE COMPANY OF CANADA | $194K | — | $194K | 5.22% |
| ENROLLEASE3 Filed as: STRATEGIC BENEFIT ADVISORS, INC | 144 TURPIKE ROAD STE 330 SOUTHBOROUGH, MA 01772 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $81K | $81K | 2.19% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $206K | — | $206K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS, LLC | 980 WASHINGTON STREET SUITE 325 DEDHAM, MA 02026 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $23K | $23K | 1.10% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $545 | $545 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | D/B/A STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $27K | — | $27K | 9.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS | D/B/A STRATEGIC BENEFIT ADVISORS 144 TURNPIKE ROAD, SUITE 330 SOUTHBOROUGH, MA 01772 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $173 | — | $173 | 8.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATION | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Participant communication Service code 12 | — | $2.5M |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 THIRD PARTY ADMIN FEES | Contract Administrator Service code 13 | — | $200K |
| COMPSYCH EIN 35-3739783 THIRD PARTY ADMIN FEES | Contract Administrator Service code 13 | — | $14K |
| CIGNA | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $0 |
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 | 3,002 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,017 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF ARIZONA | 4,523 | $2.5M |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 5,021 | $283K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,970 | $2.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,970 | $2.1M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,470 | $3.7M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,970 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,021 | — |
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.