| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $2K | $10K | 5.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | — | $35 | $35 | 0.02% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | METROPOLITAN LIFE INSURANCE COMPANY | $6 | $13 | $19 | 0.01% |
| KATTY W COHEN3 Filed as: KATTY W. COHEN | 21711 TOWN PLACE DRIVE BOCA RATON, FL 33433 | AFLAC | $7K | — | $7K | 10.94% |
| JAVIER ORTIZ3 | 11900 BISCAYNE BLVD MIAMI, FL 33181 | AFLAC | $1K | — | $1K | 1.81% |
| MICHAEL K PORTER3 | 4000 HOLLYWOOD BLVD STE 555S HOLLYWOOD, FL 33021 | AFLAC | $613 | — | $613 | 1.03% |
| EMILY B WAYMAN3 | 1350 SW 12TH TERR BOCA RATON, FL 33486 | AFLAC | $378 | — | $378 | 0.63% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $265 | — | $265 | 0.44% |
| BRENDA LYNN GARRETT3 | 1350 FRONT PL UNIT 5102 NORTH PORT, FL 34287 | AFLAC | $243 | — | $243 | 0.41% |
| PLASTRIDGE AGENCY INC3 | 820 NE 6TH AVE DELRAY BEACH, FL 33483 | AFLAC | $156 | — | $156 | 0.26% |
| JOSHUA BUZZARD3 | 6848 HENDRY DR LAKE WORTH, FL 33463 | AFLAC | $124 | — | $124 | 0.21% |
| ELIZABETH GUZMAN3 | 10623 NW 6TH CT CORAL SPRINGS, FL 33071 | AFLAC | $106 | — | $106 | 0.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $90 | — | $90 | 0.15% |
| BARRY BAYUK3 Filed as: BARRY M BAYUK | 7193 VENETO DRIVE BOYNTON BEACH, FL 33437 | AFLAC | $43 | — | $43 | 0.07% |
| C HUDSON AND ASSOCIATES3 | 2843 TWIN PINE RD THOMSON, GA 30824 | AFLAC | $29 | — | $29 | 0.05% |
| LUIS M HERNANDEZ-ROSADO3 | 2190 SAINT MARTINS DR E JACKSONVILLE, FL 32246 | AFLAC | $23 | — | $23 | 0.04% |
| NADIA DIAZ NORRIS3 | 4572 CONCORDIA LN BOYNTON BEACH, FL 33436 | AFLAC | $23 | — | $23 | 0.04% |
| KENDALL C HUDSON3 | 1645 PALM BEACH LAKES BLVD STE 1200 WEST PALM BEACH, FL 33401 | AFLAC | $20 | — | $20 | 0.03% |
| TALLON AND ASSOCIATES INC3 Filed as: TALLON BENEFITS, INC | PO BOX 30668 PALM BEACH GARDENS, FL 33420 | AFLAC | $19 | — | $19 | 0.03% |
| MICHAEL A ORTIZ3 | 740 CHEYENNE LN ELGIN, IL 60123 | AFLAC | $18 | — | $18 | 0.03% |
| SUWAT ASSAWAMATIYANONT3 Filed as: SUWAT ASSAWAMATIYANOT | 7294 PANACHE WAY BOCA RATON, FL 33433 | AFLAC | $17 | — | $17 | 0.03% |
| FRANK ROBERT SOBOCINSKI3 Filed as: FRANK SOBOCINSKI | 528 SWEET BAY CIR JUPITER, FL 33458 | AFLAC | $12 | — | $12 | 0.02% |
| HAROLD L STAFFORD3 | 8544 TOWNLEY RD APT 1B HUNTERSVILLE, NC 28078 | AFLAC | $12 | — | $12 | 0.02% |
| J W GRIMES INC3 | 6165 WATERFORD RD COLUMBUS, GA 31904 | AFLAC | $11 | — | $11 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH WILLIS JR | 1431 NE 55TH ST FORT LAUDERDALE, FL 33334 | AFLAC | $9 | — | $9 | 0.02% |
| TALLON AND ASSOCIATES INC3 | PO BOX 30668 PALM BEACH, FL 78130 | AFLAC | $7 | — | $7 | 0.01% |
| WORLDWIDE BENEFITS INC3 | 573 NW 55TH BOCA RATON, FL 33487 | AFLAC | $5 | — | $5 | 0.01% |
| DEXTER ANTONIO HARRIS3 | 100 GALLERIA PKWY SE STE 900 ATLANTA, GA 30339 | AFLAC | $4 | — | $4 | 0.01% |
| SUSAN P WATLEY3 Filed as: SUSAN WATLEY | 6366 INDEPENDENCE DR COLUMBUS, GA 31909 | AFLAC | $4 | — | $4 | 0.01% |
| DEBORAH L JONGES3 | PO BOX 31994 PALM BEACH GARDENS, FL 33420 | AFLAC | $3 | — | $3 | 0.01% |
| MARK C LEE3 Filed as: MARK LEE | 1444 SOUTH 17TH ST WILMINGTON, NC 28401 | AFLAC | $1 | — | $1 | 0.00% |
| THOMAS R BAILEY3 Filed as: THOMAS BAILEY | 142 MAPLE COURT NW CHARLESTON, TN 37310 | AFLAC | $1 | — | $1 | 0.00% |
| OMER S BASS IV3 | 565 W GATEWAY CT MERRITT ISLAND, FL 32952 | AFLAC | $0 | — | $0 | 0.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS INC. A FLORIDA CORPORATION | $347 | $69 | $416 | 6.12% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | SAFEGUARD HEALTH PLANS INC. A FLORIDA CORPORATION | -$12 | -$2 | -$14 | -0.21% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATION FEES | Other services; Participant communication; Claims processing; Direct payment from the plan; Non-monetary compensation; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $22K |
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 | 307 | 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) | 307 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $625K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $176K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $169K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $169K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $169K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $169K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 307 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 307 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.