| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | AETNA LIFE INSURANCE CO. | $5K | $6K | $12K | 1.13% |
| MARSH & MCLENNAN AGENCY LLC3 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 21.05% |
| MARSH & MCLENNAN AGENCY LLC5 | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.67% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 1000 CORPORATE DRIVE SUITE 400 FORT LAUDERDALE, FL 33334 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $533 | — | $533 | 7.61% |
| BENETEK CORPORATION3 | 4725 WEST SAND LAKE ROAD SUITE 300 ORLANDO, FL 32819 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $164 | — | $164 | 2.34% |
| ROBERT D. WIEGENSTEIN3 Filed as: ROBERT D WIEGENSTEIN | AND VARIOUS OTHER BROKERS 1117 E CRIMM RD SAN TAN VALLEY, AZ 85143 | AFLAC | $774 | $0 | $774 | 11.32% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOCIATES INC | 110 CARILLON PKWY ST PETERSBURG, FL 33716 | AFLAC | $164 | $0 | $164 | 2.40% |
| ADRIANNE WIEGENSTEIN3 | 1117 E CRIMM RD SAN TAN VALLEY, AZ 85143 | AFLAC | $100 | $0 | $100 | 1.46% |
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 | 141 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 141 | $1.1M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 141 | $1.1M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 130 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $51K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $51K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $51K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.