| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH SULLIVAN3 Filed as: JOSEPH P SULLIVAN | 1105 NIKKI VIEW DR BRANDON, FL 33511 | SUN LIFE ASSURANCE COMPANY OF CANADA | $68K | — | $68K | 10.00% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVE STE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $8K | $8K | 1.23% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC. DBA SULLIVAN | 10672 BLOOMINGDALE AVENUE RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $68K | — | $68K | 10.02% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $29K | $4K | $33K | 12.29% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 33511 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $9K | $20K | 7.50% |
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | $3K | $25K | 11.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $319K |
| REFINED BENEFITS INC EIN 59-3562048 BROKER | Other commissions Service code 55 | 10672 BLOOMINGDALE AVENUE RIVERVIEW, FL 33578 | $63K |
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 | 418 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 367 | $216K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 367 | $216K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 410 | $265K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 410 | $265K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 410 | $265K |
| Stop-loss / reinsurancereinsurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 411 | $1.4M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 410 | $265K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.