| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL, INC. | 1200 PLANTATION ISLAND DRIVE SOUTH SUITE 210 ST. AUGUSTINE, FL 32080 | SUN LIFE ASSURANCE COMPANY OF CANADA | $201K | $43K | $243K | 23.08% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES | 109 LAURENS ROAD SUITE 1A GREENVILLE, SC 29607 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $6K | $6K | 0.56% |
| THE BAILEY GROUP3 | 1200 PLANTATION ISLAND DRIVE ST. AUGUSTINE, FL 32080 | HUMANA INSURANCE COMPANY | $109K | $9K | $118K | 16.46% |
| MILLER MILLER BRADWISH & MILLER PA3 Filed as: MILLER, MILLER BRADWISH & MILLER PA | P.O. BOX 10099 JACKSONVILLE, FL 32247 | HUMANA INSURANCE COMPANY | $4K | $0 | $4K | 0.61% |
| THE BAILEY GROUP3 | 1200 PLANTATION ISLAND DRIVE #210 ST. AUGUSTINE, FL 32080 | FLORIDA BLUE | $53K | — | $53K | 15.00% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE SUITE 210 ST. AUGUSTINE, FL 32080 | HUMANA INSURANCE COMPANY | $11K | $7K | $18K | 13.95% |
| MILLER MILLER BRADWISH & MILLER PA3 | P.O. BOX 10099 JACKSONVILLE, FL 32247 | HUMANA INSURANCE COMPANY | $516 | $0 | $516 | 0.41% |
| THE BAILEY GROUP3 | 1200 PLANTATION ISLAND DRIVE SOUTH ST. AUGUSTINE, FL 32080 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $23K | $883 | $24K | 20.75% |
| THE BAILEY GROUP3 | 1200 PLANTATION ISLAND DRIVE ST. AUGUSTINE, FL 32080 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | $813 | $14K | 21.27% |
| MFB FINANCIAL INC4 Filed as: MFB FINANCIAL INC. DBA THE BAILEY G | 1200 PLANTATION ISLAND DRIVE SUITE 210 ST. AUGUSTINE, FL 32080 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $9K | $0 | $9K | 23.11% |
| CHARLES B ZITSMAN4 Filed as: CHARLES B. ZITSMAN | 3521 KINGS ROAD, SOUTH ST. AUGUSTINE, FL 32086 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $7K | $0 | $7K | 18.96% |
| MATT CASTO4 | 1700 WHITFIELD ROAD SE EAST GRAND RAPIDS, MI 49506 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $7K | $0 | $7K | 17.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA EIN 59-2015694 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 4800 DEERWOOD CAMPUS PARKWAY DCC 8-4 JACKSONVILLE, FL 32246 | $859K |
| MFB FINANCIAL INC. EIN 59-3391619 INSURANCE AGENTS | Insurance agents and brokers Service code 22 | 1200 PLANTATION ISLAND DRIVE SOUTH SUITE 210 ST. AGUSTINE, FL 32080 | $0 |
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 | 1,631 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 1,631 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,905 | $1.1M |
| Stop-loss / reinsurancereinsurance | FLORIDA BLUE | 1,631 | $354K |
| Other(6 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,905 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,905 | — |
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.