| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LARRY C. COOK3 | 10793 118TH TERRACE LIVE OAK, FL 32060 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 2.50% |
| WILLIAM C. GOODLAD3 | 701 US HIGHWAY ONE N, STE 404 NORTH PALM BEACH, FL 33408 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 1.90% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: ELLEN H. GALLAGHER | 122 REDWOOD DRIVE JUPITER, FL 33458 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.60% |
| WILLIAM C. GOODLAD3 | 701 US HIGHWAY ONE N, STE 404 NORTH PALM BEACH, FL 33408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.62% |
| LARRY C. COOK3 | 10793 118TH TERRACE LIVE OAK, FL 32060 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.62% |
| WILLIAM C. GOODLAD3 | 701 US HIGHWAY ONE N, STE 404 NORTH PALM BEACH, FL 33408 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 4.60% |
| LARRY C. COOK3 | 10793 118TH TERRACE LIVE OAK, FL 32060 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 4.59% |
| WILLIAM C. GOODLAD3 | 701 US HIGHWAY ONE N, STE 404 NORTH PALM BEACH, FL 33408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 7.60% |
| LARRY C. COOK3 | 10793 118TH TERRACE LIVE OAK, FL 32060 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 7.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONWIDE INSURANCE COMPANY EIN 31-1432329 NONE | Contract Administrator Service code 13 | — | $1.0M |
| CIGNA PPO EIN 59-1031071 NONE | Contract Administrator Service code 13 | 900 COTTAGE GROVE ROAD HARTFORD, CT 06152 | $115K |
| FLORIDA HEALTH ADMINISTRATORS EIN 65-1064109 NONE | Contract Administrator Service code 13 | 6941 SW 196 AVE, STE 27 FORT LAUDERDALE, FL 33332 | $112K |
| OPTUM HEALTH NONE | Contract Administrator Service code 13 | 13621 NW 12TH ST 800-825-8792 SUNRISE, FL 33323 | $49K |
| LARRY COOK INC EIN 65-0059195 NONE | Insurance agents and brokers Service code 22 | 2718 NORTH SIDE DRIVE LANTANA, FL 33462 | $37K |
| WILLIAM C. GOODLAD EIN 15-8369913 NONE | Insurance agents and brokers Service code 22 | 701 HIGHWAY ONE N STE 404 NORTH PALM BEACH, FL 33408 | $37K |
| ANGELO SCHIRALLI EIN 30-3505119 NONE | Insurance agents and brokers Service code 22 | 701 HIGHWAY ONE, STE 401 WEST PALM BEACH, FL 33408 | $19K |
| TRIZETTO NONE | Actuarial Service code 11 | 9655 MAROON CIRCLE 800-569-1222 ENGLEWOOD, CO 80112 | $6K |
| TELADOC NONE | Contract Administrator Service code 13 | 2 MANHATTANVILLE ROAD PURCHASE, NY 10577 | $779 |
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 | 1,021 | 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) | 1,021 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 967 | $48K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 967 | $48K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 967 | $48K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 967 | $276K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $150K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 967 | — |
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.