| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 0.69% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $9K | $15K | 9.96% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $253 | $2K | 1.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | — | $39 | $39 | 0.03% |
| KATTY W COHEN3 Filed as: KATTY W. COHEN | 21711 TOWN PLACE DRIVE BOCA RATON, FL 33433 | AFLAC | $4K | $215 | $5K | 8.13% |
| JAVIER ORTIZ3 | 9620 NE 2ND AVE STE 203 MIAMI SHORES, FL 33138 | AFLAC | $832 | $40 | $872 | 1.51% |
| EMILY B WAYMAN3 | 1350 SW 12TH TERR BOCA RATON, FL 33486 | AFLAC | $468 | — | $468 | 0.81% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $313 | $40 | $353 | 0.61% |
| MICHAEL K PORTER3 | 4000 HOLLYWOOD BLVD STE 555S HOLLYWOOD, FL 33021 | AFLAC | $313 | — | $313 | 0.54% |
| PLASTRIDGE AGENCY INC3 | 820 NE 6TH AVE DELRAY BEACH, FL 33483 | AFLAC | $209 | — | $209 | 0.36% |
| BRENDA LYNN GARRETT3 | 12475 KENTWOO AVE FORT MYERS, FL 33913 | AFLAC | $181 | — | $181 | 0.31% |
| JOSHUA BUZZARD3 | 6848 HENDRY DR LAKE WORTH, FL 33463 | AFLAC | $173 | — | $173 | 0.30% |
| BRENDA LYNN GARRETT3 | 1411 CENTERPOINT CIR APT 103 SHILOH, IL 62269 | AFLAC | $155 | — | $155 | 0.27% |
| ELIZABETH GUZMAN3 | 10623 NW 6TH CT CORAL SPRINGS, FL 33071 | AFLAC | $115 | — | $115 | 0.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AFLAC | $108 | — | $108 | 0.19% |
| BARRY BAYUK3 Filed as: BARRY M BAYUK | 7193 VENETO DRIVE BOYNTON BEACH, FL 33437 | AFLAC | $47 | — | $47 | 0.08% |
| C HUDSON AND ASSOCIATES3 | 2843 TWIN PINE RD THOMSON, GA 30824 | AFLAC | $32 | — | $32 | 0.06% |
| TALLON AND ASSOCIATES INC3 | PO BOX 30668 PALM BEACH GARDENS, FL 33420 | AFLAC | $29 | — | $29 | 0.05% |
| LUIS M HERNANDEZ-ROSADO3 | 2190 SAINT MARTINS DR E JACKSONVILLE, FL 32246 | AFLAC | $25 | — | $25 | 0.04% |
| NADIA DIAZ NORRIS3 | 4572 CONCORDIA LN BOYNTON BEACH, FL 33436 | AFLAC | $25 | — | $25 | 0.04% |
| SUWAT ASSAWAMATIYANONT3 Filed as: SUWAT ASSAWAMATIYANOT | 8171 HAMPTON WOOD APT 505 BOCA RATON, FL 33433 | AFLAC | $21 | — | $21 | 0.04% |
| KENDALL C HUDSON3 | 1645 PALM BEACH LAKES BLVD STE 1200 WEST PALM BEACH, FL 33401 | AFLAC | $21 | — | $21 | 0.04% |
| MICHAEL A ORTIZ3 | 740 CHEYENNE LN ELGIN, IL 60123 | AFLAC | $20 | — | $20 | 0.03% |
| FRANK ROBERT SOBOCINSKI3 Filed as: FRANK SOBOCINSKI | 528 SWEET BAY CIR JUPITER, FL 33458 | AFLAC | $15 | — | $15 | 0.03% |
| HAROLD L STAFFORD3 | 8544 TOWNLEY RD APT 1B HUNTERSVILLE, NC 28078 | AFLAC | $13 | — | $13 | 0.02% |
| J W GRIMES INC3 | 6165 WATERFORD RD COLUMBUS, GA 31904 | AFLAC | $12 | — | $12 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: JOSEPH WILLIS JR | 1431 NE 55TH ST FORT LAUDERDALE, FL 33334 | AFLAC | $11 | — | $11 | 0.02% |
| 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 | $5 | — | $5 | 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% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $2 | — | $2 | 0.00% |
| MARK C LEE3 Filed as: MARK LEE | 1444 SOUTH 17TH ST WILMINGTON, NC 28401 | AFLAC | $2 | — | $2 | 0.00% |
| THOMAS R BAILEY3 Filed as: THOMAS BAILEY | 142 MAPLE COURT NW CHARLESTON, TN 37310 | AFLAC | $1 | — | $1 | 0.00% |
| JUAN C FERLINI3 | 891 MAYBERRY ML NEW BRAUNFELS, TX 78130 | AFLAC | $0 | — | $0 | 0.00% |
| OMER S BASS IV3 | 565 W GATEWAY CT MERRITT ISLAND, FL 32952 | AFLAC | $0 | — | $0 | 0.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 STE 368 WALL, NJ 07719 | SAFEGUARD HEALTH PLANS INC. A FLORIDA CORPORATION | $300 | $510 | $810 | 10.99% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS INC. A FLORIDA CORPORATION | — | $14 | $14 | 0.19% |
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 | 287 | 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) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 177 | $553K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $156K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $148K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $148K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $148K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $148K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 287 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.