| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | SYMETRA LIFE INSURANCE COMPANY | — | $15K | $15K | 3.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHONY L ROUNDTREE EIN 59-0834277 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $220K |
| ERWIN LAX EIN 59-0834277 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $191K |
| LORRAINE WILLIAMS EIN 59-0834277 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $120K |
| CYNTHIA POWELL EIN 59-0834277 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $98K |
| TOYER T DORSEY EIN 59-0834277 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| CHARO SIMPSON EIN 59-0834277 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $62K |
| TERRIE Y JACHO-SWANIGAN EIN 59-0834277 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $55K |
| VENTURE POINTE NONE | Consulting (general); Direct payment from the plan Service code 16 | 8659 BAYPINE ROAD SUITE 106 JACKSONVILLE, FL 32256 | $51K |
| MOSELEY, PRICHARD, PARRISH, KNIGHT EIN 59-1309328 NONE | Legal; Direct payment from the plan Service code 29 | — | $49K |
| GEOGRAMETRIX INC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 9838 OLD BAYMEADOWS RD JACKSONVILLE, FL 32256 | $48K |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $47K |
| WYNETTA MCGRAW EIN 59-0834277 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $37K |
| THE LAMBOS FIRM EIN 13-3864093 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| SMITH, GAMBRELL & RUSSELL, LLP EIN 58-0967450 NONE | Legal; Direct payment from the plan Service code 29 | — | $11K |
| ELAN FINANCIAL SERVICES NONE | Direct payment from the plan; Consulting (general) Service code 16 | P.O. BOX 790408 ST. LOUIS, MO 631790408 | $6K |
| PENSION BOARD CONSULTANTS EIN 59-1997474 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $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 | 618 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 190 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 139 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 808 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 808 | $423K |
| Other | SYMETRA LIFE INSURANCE COMPANY | 808 | $423K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 808 | — |
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.