| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 200 SOUTH ORANGE AVENUE, SUITE 750 ORLANDO, FL 32801 | UNITEDHEALTHCARE INSURANCE COMPANY | $150K | $0 | $150K | 3.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 265 EXCHANGE DRIVE CRYSTAL LAKE, IL 60014 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $5K | $5K | 0.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $38K | $0 | $38K | 13.75% |
| SHELLIE GASKINS3 | 510 22ND STREET SAINT AUGUSTINE, FL 32084 | AFLAC | $5K | $70 | $5K | 5.14% |
| MICHAEL S WITHROW3 Filed as: MICHAEL WITHROW & OTHER AGENTS | 1396 BARRINGTON CIRCLE SAINT AUGUSTINE, FL 32092 | AFLAC | $4K | $33 | $4K | 3.99% |
| KEGAN NICOLE GONZALEZ3 Filed as: KEGAN GONZALEZ | 153 BLANDING BOULEVARD, SUITE 3 ORANGE PARK, FL 32073 | AFLAC | $2K | $0 | $2K | 2.23% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: DANA BROWN | 45226 INGLEHAM CIRCLE CALLAHAN, FL 32011 | AFLAC | $2K | $0 | $2K | 1.70% |
| SALLY L PITTMAN3 Filed as: SALLY PITTMAN | 9372 COXWELL LANE JACKSONVILLE, FL 32221 | AFLAC | $1K | $0 | $1K | 1.60% |
| DENNIS PITTMAN3 | 9372 COXWELL LANE JACKSONVILLE, FL 32221 | AFLAC | $819 | $0 | $819 | 0.91% |
| THOMAS JAMES OLLER3 Filed as: THOMAS OLLER | 2410 SOUTHERN LINKS DRIVE FLEMING ISLAND, FL 32003 | AFLAC | $730 | $0 | $730 | 0.81% |
| REBECCA J SMITH INC3 Filed as: REBECCA J. SMITH, INC. | 2557 MICHAELSON WAY JACKSONVILLE, FL 32223 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 15.12% |
| KATHLEEN DEANNE NORTON LLC4 Filed as: KATHLEEN DEANNE NORTON, LLC | 6050 GREEN POND DRIVE JACKSONVILLE, FL 32258 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $52 | — | $52 | 0.44% |
| BROOKE B. WARD3 | 2557 MICHAELSON WAY JACKSONVILLE, FL 32223 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $42 | $0 | $42 | 0.36% |
| LIVING LEGACY BENEFITS GROUP LLC4 Filed as: LIVING LEGACY BENEFITS GROUP, LLC | 5807 HAMPTON CREEK ROAD JACKSONVILLE, FL 32218 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $23 | — | $23 | 0.20% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | HARTFORD FIRE INSURANCE COMPANY | $150 | $38 | $188 | 25.07% |
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 | 442 | 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) | 442 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,039 | $5.0M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,039 | $5.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,039 | $5.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 442 | $276K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 442 | $276K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 442 | $276K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 1,039 | $5.0M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 442 | $378K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,039 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.