| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS ST STE 100 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $18K | — | $18K | 5.00% |
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS ST STE 100 TAMPA, FL 33607 | HEALTH OPTIONS | $10K | — | $10K | 5.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 11.20% |
| TAMRA KSIAZEK3 | 804 E. WINDWARD WAY APT 511 LANTANA, FL 33462 | AFLAC | $2K | $373 | $2K | 17.27% |
| STEVE SERVI3 | 6127 S RAINBOW BLVD SUITE 110 LAS VEGAS, NV 89118 | AFLAC | $394 | $75 | $469 | 3.56% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DRIVE BOCA RATON, FL 33433 | AFLAC | $377 | $75 | $452 | 3.43% |
| SHAZAM BENEFITS INC3 | 804 E WINDWARD WAY APT 511 LANTANA, FL 33462 | AFLAC | $328 | — | $328 | 2.49% |
| MICHELLE LAMPERT3 Filed as: MICHELLE T DUBE | 251 ROYAL CT DELRAY BEACH, FL 33444 | AFLAC | $142 | — | $142 | 1.08% |
| JOANNE M SCUDERI3 | 251 ROYAL CT DELRAY BEACH, FL 33444 | AFLAC | $129 | — | $129 | 0.98% |
| EMILY B WAYMAN3 | 1199 SOUTH FEDERAL HIGHWAY SUITE 155 BOCA RATON, FL 33432 | AFLAC | $10 | — | $10 | 0.08% |
| JAVIER ORTIZ3 | 165 NE 96TH STREET MIAMI SHORES, FL 33138 | AFLAC | $8 | — | $8 | 0.06% |
| MARIALENA SELVAGGIO3 | 1685 SW 4TH AVE BOCA RATON, FL 33432 | AFLAC | $6 | — | $6 | 0.05% |
| PLASTRIDGE AGENCY INC3 | 820 NE 6TH AVE DELRAY BEACH, FL 33483 | AFLAC | $4 | — | $4 | 0.03% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $4 | — | $4 | 0.03% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD SUITE 434 LONGWOOD, FL 32750 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $86 | $1K | 16.13% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD SUITE 434 LONGWOOD, FL 32750 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $691 | $50 | $741 | 16.09% |
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 | 75 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 76 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 82 | $389K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 82 | $27K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 82 | $27K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 82 | $27K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 29 | $8K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 22 | $5K |
| Prescription drug | HEALTH OPTIONS | 22 | $210K |
| Other | AFLAC | 41 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 82 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.