| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: VARIOUS AGENTS- LIST ATTACHED | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $82K | $11K | $93K | 33.78% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DRIVE SUITE 102 BRANDON, FL 33511 | GUARDIAN LIFE INSURANCE COMPANY | $15K | $7K | $22K | 12.49% |
| ROGER BOUCHARD INSURANCE INC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 1.49% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $7K | $16K | 12.87% |
| ROGER BOUCHARD INSURANCE INC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 2.69% |
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 | 1,076 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,090 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 438 | $172K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY | 438 | $172K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 652 | $403K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 652 | $128K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 652 | $128K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 652 | $403K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 652 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.