| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $40K | — | $40K | 13.27% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | GUARDIAN | $7K | $0 | $7K | 10.00% |
| DAVIS II COMPANIES LLC3 | 5426 DAY CENTER DR. TAMPA, FL 33609 | GUARDIAN | $281 | $0 | $281 | 0.38% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE., STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.42% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE., STE 102 RIVERVIEW, FL 33578 | UNITED MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | UNITED MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $0 | $903 | $903 | 5.28% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGTON AVE., STE 102 RIVERVIEW, FL 33578 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $630 | $0 | $630 | 9.99% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGTON AVE., STE 102 RIVERVIEW, FL 33578 | ADVANTICA INSURANCE COMPANY | $604 | $0 | $604 | 9.87% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGTON AVE., STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $655 | $0 | $655 | 15.01% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $145 | $145 | 3.32% |
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 | 187 | 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) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 181 | $305K |
| Dental | GUARDIAN | 164 | $74K |
| Vision(2 contracts, 2 carriers) | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 192 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $31K |
| Short-term disability | UNITED MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 56 | $17K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.