| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISION HR AGENCY INC3 Filed as: VISION HR AGENCY, INC | 347 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | BLUE CROSS BLUE SHIELD OF FLORIDA | $20K | — | $20K | 2.97% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE INC. | PO BOX 6090 CLEARWATER, FL 33758 | BLUE CROSS BLUE SHIELD OF FLORIDA | $7K | — | $7K | 1.03% |
| VISION HR AGENCY INC3 Filed as: VISION HR | 347 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | FLORIDA HEALTH CARE PLANS, INC. | $7K | — | $7K | 3.92% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DRIVE CLEARWATER, FL 33765 | FLORIDA HEALTH CARE PLANS, INC. | $2K | — | $2K | 1.34% |
| VISION HR AGENCY INC3 Filed as: VISION HR AGENCY, INC | 347 S RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | BLUE CROSS BLUE SHIELD OF FLORIDA | $3K | — | $3K | 3.02% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE, INC. | PO BOX 6090 CLEARWATER, FL 33758 | BLUE CROSS BLUE SHIELD OF FLORIDA | $1K | — | $1K | 0.98% |
| VARIOUS - SEE ATTACHED3 | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29K | $2K | $31K | 32.14% |
| VISION HR AGENCY INC3 | 347 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.77% |
| ROGER BOUCHARD INSURANCE INC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $199 | — | $199 | 0.35% |
| VISION HR AGENCY INC3 | 347 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 8.96% |
| ROGER BOUCHARD INSURANCE INC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $599 | — | $599 | 4.04% |
| VISION HR AGENCY INC3 | 347 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 8.92% |
| ROGER BOUCHARD INSURANCE INC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $502 | — | $502 | 4.08% |
| VISION HR AGENCY INC3 | 347 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $220 | — | $220 | 2.18% |
| ROGER BOUCHARD INSURANCE INC3 | 347 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | STANDARD INSURANCE COMPANY | $35 | — | $35 | 0.35% |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 112 | $970K |
| Dental | STANDARD INSURANCE COMPANY | 121 | $57K |
| Vision | STANDARD INSURANCE COMPANY | 89 | $10K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 118 | $112K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 118 | $98K |
| Long-term disability | STANDARD INSURANCE COMPANY | 34 | $12K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 112 | $799K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 118 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.
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.