| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PALMER CAY-CARSWELL INC | 1 INDEPENDENT DR STE 630 JACKSONVILLE, FL 322025007 | UNITED HEALTHCARE INSURANCE COMPANY | — | $96K | $96K | 4.17% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 76 S LAURA ST STE 1400 JACKSONVILLE, FL 322025403 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 2.19% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 203334 FLORIDA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 9.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERV USA INC | PO BOX 201629 DALLAS, TX 753201629 | HUMANA INSURANCE COMPANY OF NEW YORK | $4K | — | $4K | 10.02% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 203334 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 203334 FLORIDA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 203334 FLORIDA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
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 | 240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 402 | $2.3M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 530 | $198K |
| Vision | HUMANA INSURANCE COMPANY OF NEW YORK | 240 | $40K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $158K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 403 | $39K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $32K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 402 | $2.3M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 402 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 530 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.