| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE DAVID JARR | 5310 CLARK RD, STE 1 SARASOTA, FL 342333230 | HEALTH OPTIONS, INC. | $34K | — | $34K | 4.00% |
| ROGER BOUCHARD INSURANCE INC Filed as: ROGER BOUCHARD INSURANCE | 101 STARCREST DRIVE NORTH CLEARWATER, FL 33765 | ATENA LIFE INSURANCE CO. | $7K | — | $7K | 8.99% |
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 | 235 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ATENA LIFE INSURANCE CO. | 235 | $82K |
| Vision | ATENA LIFE INSURANCE CO. | 235 | $82K |
| Life insurance | ATENA LIFE INSURANCE CO. | 235 | $82K |
| Other | ATENA LIFE INSURANCE CO. | 235 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.