| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLORINE BELLUS3 | PO BOX 1820 WINTER PARK, FL 32790 | AETNA LIFE INSURANCE COMPANY | $69K | — | $69K | 5.01% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BUILDING 3 500 AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $7K | — | $7K | 0.49% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY, INC. | 6300 BRIDGEPOINT PARKWAY BUILDING 3 500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $143K | — | $143K | 16.36% |
| FLORINE BELLUS3 | P O BOX 1820 WINTER PARK, FL 32790 | TRANSAMERICA LIFE INSURANCE COMPANY | $6K | — | $6K | 0.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES, INC. EIN 33-0449333 NONE | Insurance services; Direct payment from the plan; Contract Administrator; Float revenue; Claims processing Service code 12 | 6300 BRIDGEPOINT PARKWAY BUILDING 3 500 AUSTIN, TX 78730 | $269K |
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 | 469 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 525 | $2.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Vision | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Other | AETNA LIFE INSURANCE COMPANY | 215 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 525 | — |
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.