| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DRIVE CLEARWATER, FL 33765 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $50K | $3K | $54K | 11.24% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DRIVE CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | $8K | $29K | 19.52% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DRIVE CLEARWATER, FL 33765 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $7K | $21K | 15.42% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE AMERICA LLC | 14141 46TH ST N SUITE 1209 CLEARWATER, FL 33765 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.30% |
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 34618 | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.62% |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 258 | $476K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 248 | $138K |
| Vision | EYEMED VISION CARE OBO FIDELITY SECURITY LIFE INSURANCE COMPANY | 318 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $150K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $150K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 353 | $288K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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.