| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS, INC. | 10672 BLOOMINGDALE AVE SUITE 102 RIVERVIEW, FL 33578 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $40K | $40K | 4.97% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $4K | $14K | 17.54% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHED LIST | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $401 | $4K | 10.36% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 1105 NIKKI VIEW DR BRANDON, LA 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.34% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC. | 200 GALLERIA PARKWAY ST. SUITE 1950 ATLANTA, GA 303395946 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $479 | — | $479 | 1.66% |
| DAVIS II COMPANIES LLC3 | 5426 BAY CENTER DRIVE SUITE 550 TAMPA, FL 336093406 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $92 | — | $92 | 0.32% |
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 | 140 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 93 | $802K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 74 | $29K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $79K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $79K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.