| 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 | 5.05% |
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS ST STE 100 TAMPA, FL 33607 | HEALTH OPTIONS | $10K | — | $10K | 5.01% |
| SHAZAM BENEFITS INC3 | 804 E WINDWARD WAY APT 511 LANTANA, FL 33462 | AFLAC | $4K | $19 | $4K | 16.07% |
| MARIALENA SELVAGGIO3 | 1685 SW 4TH AVE BOCA RATON, FL 33432 | AFLAC | $2K | — | $2K | 9.86% |
| JAMES SMITH3 Filed as: JAMES B SMITH | 100 NW 62ND ST SUITE 110 FT. LAUDERDALE, FL 33309 | AFLAC | $651 | — | $651 | 2.94% |
| STEVE SERVI3 | 6127 S RAINBOW BLVD SUITE 110 LAS VEGAS, NV 89118 | AFLAC | $188 | — | $188 | 0.85% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DRIVE BOCA RATON, FL 33433 | AFLAC | $136 | $7 | $143 | 0.65% |
| JOANNE M SCUDERI3 | 251 ROYAL CT DELRAY BEACH, FL 33444 | AFLAC | $42 | $17 | $59 | 0.27% |
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS ST SUITE 100 TAMPA, FL 336073846 | FLORIDA COMBINED LIFE | $2K | — | $2K | 9.23% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD SUITE 434 LONGWOOD, FL 32750 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 13.22% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD SUITE 434 LONGWOOD, FL 32750 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 21.53% |
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 | 88 | 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) | 89 | 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 | 95 | $356K |
| Dental(2 contracts, 2 carriers) | FLORIDA COMBINED LIFE | 95 | $29K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 95 | $8K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 95 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 7 | $8K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 7 | $6K |
| Prescription drug | HEALTH OPTIONS | 24 | $199K |
| Other | AFLAC | 32 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 95 | — |
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.