| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | HEALTH OPTIONS | $55K | — | $55K | 7.00% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | BLUE CROSS BLUE SHIELD OF FLORIDA | $17K | — | $17K | 7.00% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $2K | $2K | 1.57% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 1.00% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 14.78% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | CIGNA GROUP INSURANCE | $7K | — | $7K | 20.00% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $397 | $397 | 3.32% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $155 | — | $155 | 1.30% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | HUMANA | $2K | $149 | $2K | 21.58% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $737 | — | $737 | 8.43% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $189 | $189 | 2.16% |
| MFB FINANCIAL INC3 | 1200 PLANTATION ISLAND DRIVE S SUITE 210 SAINT AUGUSTINE, FL 32080 | CIGNA GROUP INSURANCE | $907 | — | $907 | 20.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $103 | — | $103 | 2.63% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $18 | $18 | 0.46% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $118 | — | $118 | 5.22% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $53 | $53 | 2.35% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $8 | $8 | 0.86% |
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 | 175 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 115 | $1.0M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 103 | $70K |
| Vision | HUMANA | 78 | $9K |
| Life insurance | CIGNA GROUP INSURANCE | 175 | $34K |
| Short-term disability(2 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 72 | $16K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 87 | $108K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 115 | $1.0M |
| Other(4 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 175 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.