| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EVERLONG GROUP MED CAPTIVE SVCS.3 Filed as: EVERLONG GROUP MEDICAL | 700 COMMERCE DRIVE, STE. 500 OAK BROOK, IL 60523 | AIG BENEFIT SOLUTIONS | $16K | — | $16K | 5.33% |
| VERITAS RISK SERVICES3 | 1900 SPRING RD, STE 530 OAK BROOK, IL 60523 | AIG BENEFIT SOLUTIONS | $5K | — | $5K | 1.67% |
| INSURANCE OFFICE OF AMERICA3 | 130 VANTIS ALISO VIEJO, CA 92656 | AETNA LIFE INSURANCE CO. | $3K | — | $3K | 5.56% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 2.49% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $626 | — | $626 | 10.00% |
| INS OFFICE OF AMERICA INC-TAMPA3 Filed as: INS OFFICE OF AMERICA INC-LONGWOOD | 1855 W STATE RD 434 LONGWOOD, FL 32750 | HUMANA INSURANCE COMPANY | $622 | — | $622 | 10.00% |
| INS OFFICE OF AMERICA INC-TAMPA3 Filed as: INS OFFICE OF AMERICA INC - TAMPA | 1855 WEST STATE RD 434 LONGWOOD, FL 32750 | HUMANA INSURANCE COMPANY | — | $17 | $17 | 0.27% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 100 | $159K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 100 | $220K |
| Vision | HUMANA INSURANCE COMPANY | 38 | $6K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 125 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 113 | $21K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 100 | $159K |
| Stop-loss / reinsurancereinsurance | AIG BENEFIT SOLUTIONS | 100 | $303K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 125 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.