| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLACE WELCH & WILLINGHAM INC3 | 300 FIRST AVENUE SOUTH STREET ST. PETERSBURG, FL 33701 | AETNA LIFE INSURANCE CO. | — | $16K | $16K | 0.19% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVENUE SOUTH SUITE 500 SAINT PETERSBURG, FL 33701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 4.35% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVENUE SOUTH SUITE 500 SAINT PETERSBURG, FL 33701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.29% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVENUE SOUTH SUITE 500 SAINT PETERSBURG, FL 33701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.51% |
| WALLACE WELCH & WILLINGHAM INC3 | 300 1ST AVENUE SOUTH SUITE 500 SAINT PETERSBURG, FL 33701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 4.42% |
| BRISTOWE, RANDALL DAVID3 Filed as: BRISTOWE, RANDALL | 11234 SAN JOSE BOULEVARD SUITE 7 JACKSONVILLE, FL 32223 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 19.56% |
| RANDALL DAVID BRISTOWE3 Filed as: RANDALL BRISTOWE | 11234 SAN JOSE BOULEVARD SUITE 7 JACKSONVILLE, FL 32223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 14.95% |
| CUSTOM BENEFIT PROGRAMS INC3 | 1 NORTH WHITE HORSE PIKE SUITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $416 | $135 | $551 | 1.65% |
| SHAWN I. STUBBS3 Filed as: SHAWN STUBBS | 11234 SAN JOSE BOULEVARD SUITE 7 JACKSONVILLE, FL 32223 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $325 | $0 | $325 | 0.97% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29695 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $116 | $0 | $116 | 0.35% |
| RICHARD DOUGLAS KLIMA3 Filed as: RICHARD KLIMA | PO BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.19% |
| HEIDI S WEISHAUPT3 Filed as: HEIDI WEISHAUPT | 4520 29TH AVENUE CIRCLE EAST PALMETTO, FL 34221 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.02% |
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 | 636 | 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) | 636 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1,231 | $8.5M |
| Dental | AETNA LIFE INSURANCE CO. | 1,231 | $8.5M |
| Vision | AETNA LIFE INSURANCE CO. | 1,231 | $8.5M |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 636 | $306K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 388 | $94K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $101K |
| Prescription drug | AETNA LIFE INSURANCE CO. | 1,231 | $8.5M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 636 | $349K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,231 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.