| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES, LLC | 236 PONTE VEDRA PARK DR. STE 101 PONTE VEDRA BEACH, FL 32082 | BLUE CROSS BLUE SHIELD OF FLORIDA | $90K | $0 | $90K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 | 4233 PABLO PROFESSIONAL COURT SUITE 200 JACKSONVILLE, FL 32224 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $14K | $119 | $14K | 15.88% |
| MONTOYA AND ASSOCIATES LLC3 | 4233 PABLO PROFESSIONAL COURT SUITE 200 JACKSONVILLE, FL 32224 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | $871 | $14K | 16.72% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 1250 S CAPITAL OF TEXAS HWY BLDG 2 WEST LAKE HILLS, TX 78746 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.04% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES | 4233 PABLO PROFESSIONAL COURT SUITE 200 JACKSONVILLE, FL 32224 | HUMANA INSURANCE COMPANY | $2K | $0 | $2K | 9.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 DENTAL ADMIN | Plan Administrator; Claims processing Service code 12 | — | $12K |
| MONTOYA AND ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | $5K |
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 | 253 | 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) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 171 | $1.8M |
| Vision | HUMANA INSURANCE COMPANY | 170 | $21K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 239 | $90K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 253 | $82K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 253 | $82K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 171 | $1.8M |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 239 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.