| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICHARD S. BERNSTEIN & ASSOCIATES3 Filed as: RICHARD S BERNSTEIN & ASSOCIATES | 1551 FORUM PLACE 300 A WEST PALM BEACH, FL 33401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 1.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $34K | $3K | $38K | 16.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $4K | $25K | 13.34% |
| RICHARD S. BERNSTEIN & ASSOCIATES3 Filed as: RICHARD S BERNSTEIN & ASSOCIATES | 1551 FORUM PL 300 A WEST PALM BEACH, FL 33401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | — | $13K | 11.38% |
| HOWARTH III, FREDERICK W3 Filed as: HOWARTH FREDERICK WILLIAM | TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $467 | $128 | $595 | 0.54% |
| HOWARTH III, FREDERICK W3 Filed as: HOWARTH FREDERICK WILLIAM | III DBA TBG WEST INSURANCE SERVICES 6077 BRISTOL PARKWAY CULVER, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $140 | $140 | 0.13% |
| RICHARD S. BERNSTEIN & ASSOCIATES3 Filed as: RICHARD S BERNSTEIN & ASSOCIATES | 1551 FORUM PLACE 300 A WEST PALM BEACH, FL 33401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 15.00% |
| M PEARSON ASSOCIATES CORP3 | 1250 OLD DIXIE HIGHWAY SUITE 202 LAKE PARK, FL 33403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 25.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 24.13% |
| L A D FINANCIAL CORP3 | 3000 S HIGHWAY A1A, 202 JUPITER, FL 33477 | CONTINENTAL AMERICAN INSURANCE COMPANY | $633 | — | $633 | 1.56% |
| JOHN M PUSHKAREWICZ3 | 560 VILLAGE BLVD, STE 250 WEST PALM BEACH, FL 33409 | CONTINENTAL AMERICAN INSURANCE COMPANY | $154 | — | $154 | 0.38% |
| CYNTHIA ANN HARKINS3 | 203 EAST THATCH PALM CIRCLE JUPITER, FL 33458 | CONTINENTAL AMERICAN INSURANCE COMPANY | $132 | — | $132 | 0.33% |
| M PEARSON ASSOCIATES CORP3 | 1 BAY HARBOR RD JUPITER, FL 33469 | CONTINENTAL AMERICAN INSURANCE COMPANY | $117 | — | $117 | 0.29% |
| BRIAN GEORGE JAEGGI3 | 2875 NW 28TH ST BOCA RATON, FL 33434 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ADAMS BENEFIT CORPORATION3 Filed as: ADAMS BENEFIT CORP. (BOR) | 600 CORPORATE DRIVE, SUITE 650 FORT LAUDERDALE, FL 33334 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $4K | — | $4K | 12.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $3K | $771 | $4K | 15.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $27K |
| AETNA BEHAVORIAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $7K |
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 | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 425 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 594 | $731K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 398 | $213K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 550 | $31K |
| Life insurance | STANDARD INSURANCE COMPANY | 418 | $229K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 145 | $52K |
| Long-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 454 | $439K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 208 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 594 | — |
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.