| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 301 EAST PINE STREET, SUITE 240 ORLANDO, FL 32801 | BLUE CROSS BLUE SHIELD OF FLORIDA | $48K | $0 | $48K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 301 EAST PINE STREET, SUITE 240 ORLANDO, FL 32801 | BLUE CROSS BLUE SHIELD OF FLORIDA | $17K | $0 | $17K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $897 | $4K | 11.56% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | DELTA DENTAL INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $638 | $3K | 12.42% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | DELTA DENTAL INSURANCE COMPANY | $993 | $0 | $993 | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $930 | $0 | $930 | 10.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 102.12% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 64.58% |
| USI INSURANCE SERVICES LLC3 | ONE INTERNATIONAL PLAZA, SUITE 400 PHILADELPHIA, PA 19113 | CONTINENTAL AMERICAN INSURANCE COMPANY | $558 | $0 | $558 | 9.05% |
| CHASSE LYNN GREENE3 | 1735 BARCELONA WAY WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $222 | $0 | $222 | 3.60% |
| MORGAN STRONG3 | 735 BARCELONA WAY WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $147 | $0 | $147 | 2.38% |
| D J FISHER & ASSOC INC3 Filed as: DJ FISHER & ASSOCIATES, INC. | 4117 FAIRVIEW VISTA POINT SUITE 201 ORLANDO, FL 32804 | CONTINENTAL AMERICAN INSURANCE COMPANY | $96 | $0 | $96 | 1.56% |
| RUBEN ROSA3 | 933 LEE ROAD, SUITE 200 ORLANDO, FL 32810 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | $0 | $45 | 0.73% |
| MARY E REMSON3 Filed as: MARY ELIZABETH REMSON | 3201 POPPY HILL ROAD MOUNT DORA, FL 32757 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | $0 | $27 | 0.44% |
| NOLAN KING3 | 1215 EAST PLANT STREET, UNIT 2-314 WINTER GARDEN, FL 34787 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | $0 | $19 | 0.31% |
| USI INSURANCE SERVICES LLC3 | ONE INTERNATIONAL PLAZA, SUITE 400 PHILADELPHIA, PA 19113 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 35.19% |
| CHASSE LYNN GREENE3 | 1735 BARCELONA WAY WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $407 | $0 | $407 | 14.03% |
| MORGAN STRONG3 | 735 BARCELONA WAY WINTER PARK, FL 32789 | CONTINENTAL AMERICAN INSURANCE COMPANY | $270 | $0 | $270 | 9.31% |
| D J FISHER & ASSOC INC3 Filed as: DJ FISHER & ASSOCIATES, INC. | 4117 FAIRVIEW VISTA POINT SUITE 201 ORLANDO, FL 32804 | CONTINENTAL AMERICAN INSURANCE COMPANY | $175 | $0 | $175 | 6.03% |
| RUBEN ROSA3 | 933 LEE ROAD, SUITE 200 ORLANDO, FL 32810 | CONTINENTAL AMERICAN INSURANCE COMPANY | $82 | $0 | $82 | 2.83% |
| MARY E REMSON3 Filed as: MARY ELIZABETH REMSON | 3201 POPPY HILL ROAD MOUNT DORA, FL 32757 | CONTINENTAL AMERICAN INSURANCE COMPANY | $49 | $0 | $49 | 1.69% |
| NOLAN KING3 | 1215 EAST PLANT STREET, UNIT 2-314 WINTER GARDEN, FL 34787 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34 | $0 | $34 | 1.17% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 91 | $1.3M |
| Dental(2 contracts) | DELTA DENTAL INSURANCE COMPANY | 144 | $38K |
| Vision(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $46K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $46K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $36K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $36K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 91 | $1.3M |
| Other(4 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.