| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MULTIPLE AGENTS*3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $36K | $3K | $39K | 19.28% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF FLORIDA, LLC | 4880 NEWBERRY RD STE 180 GAINESVILLE, FL 32607 | HARTFORD LIFE AND ACCIDENT | $19K | — | $19K | 11.36% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS NL, LLC | 4500 TOWN CENTER DR STE 200 JEFFERSONVILLE, IN 47130 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29848 NETWORK PLACE CHICAGO, IL 60673 | HARTFORD LIFE AND ACCIDENT | $300 | — | $300 | 0.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $23 | $23 | 0.01% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF FLORIDA LLC | 300 COLONIAL CENTER PKWY STE 270 LAKE MARY, FL 32746 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 10.04% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF FLORIDA LLC | 8950 FONTANA DEL SOL WAY STE 300 NAPLES, FL 34109 | SUN LIFE ASSURANCE COMPANY OF CANADA | $547 | — | $547 | 5.00% |
| STEVE BAKER3 | 153 ESTHER DR COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $495 | — | $495 | 16.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HCC LIFE INSURANCE COMPANY STOP LOSS ADMIN | Contract Administrator; Claims processing Service code 12 | 225 TOWNPARK DRIVE SUITE 350 KENNESAW, GA 30144 | $391K |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $260K |
| ASSURED PARTNERS OF FL, LLC BROKER | Contract Administrator; Claims processing Service code 12 | 4880 NEWBERRY ROAD SUITE 180 GAINESVILLE, FL 32607 | $47K |
| ASSURED PARTNERS OF FLORIDA, LLC EIN 30-0720060 BROKER | Other commissions Service code 55 | — | $31K |
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 | 422 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 39 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 67 | $11K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 314 | $28K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 422 | $171K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 422 | $171K |
| Other(3 contracts, 3 carriers) | AFLAC | 422 | $375K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.