| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 887 WEST MARIETTA STREET NW SUITE N-108 ATLANTA, GA 30318 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $56K | $56K | 5.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $5K | $5K | 0.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $7K | 11.37% |
| GROUP RISK SPECIALISTS INC3 Filed as: GROUP RISK SPECIALISTS | 3340 PEACHTREE ROAD NE, SUITE 1690 ATLANTA, GA 30326 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $716 | $3K | 5.85% |
| BRYAN BARKER3 | 201 1ST STREET, SUITE 203 NEPTUNE BEACH, FL 32266 | METROPOLITAN LIFE INSURANCE COMPANY | $444 | — | $444 | 0.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 887 WEST MARRIETTA STREET NW STUDIO N-108 ATLANTA, GA 30318 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $167 | $167 | 0.58% |
| MACDOUGALL BENEFITS LLC3 Filed as: MACDOUGALL BENEFITS, LLC | 613 SOUTH POKEBERRY PLACE SAINT JOHNS, FL 32259 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $557 | $343 | $900 | 4.19% |
| RANDALL HALLMAN3 | 2632 LOOPRIDGE DRIVE ORANGE PARK, FL 32065 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $537 | — | $537 | 2.50% |
| HARDEN & ASSOCIATES3 Filed as: HARDEN AND ASSOCIATES | 501 RIVERSIDE AVENUE JACKSONVILLE, FL 32202 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $380 | — | $380 | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 887 WEST MARIETTA STREET NW SUITE N-108 ATLANTA, GA 30318 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $186 | $11 | $197 | 0.92% |
| ESTATE OF DIANNA L. CHAMBERS3 Filed as: THE ESTATE OF DIANNA L. CHAMBERS | 305 HERITAGE MILL DRIVE SAINT AUGUSTINE, FL 32084 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $150 | — | $150 | 0.70% |
| MJ INSURANCE3 Filed as: ANNALIESE CLARK AND VARIOUS AGENTS | 1336 HIDEAWAY DRIVE SOUTH SAINT JOHNS, FL 32259 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.23% |
| DOROTHY RING3 | 8300 PLAZA GATE LANE JACKSONVILLE, FL 32217 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 887 WEST MARIETTA STREET NW STUDIO N-108 ATLANTA, GA 30318 | EYEMED | $1K | — | $1K | 10.03% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 179 | $952K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 265 | $58K |
| Vision | EYEMED | 140 | $10K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 169 | $50K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 40 | $21K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 169 | $29K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 179 | $952K |
| Other(3 contracts, 3 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 182 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.