| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4350 W CYPRESS ST STE 300 TAMPA, FL 33607 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $11K | $13K | 1.75% |
| ROGER BOUCHARD INSURANCE INC3 | 101 STARCREST DR CLEARWATER, FL 33765 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 8.78% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4350 WEST CYPRESS STREET SUITE 300 TAMPA, FL 33607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.36% |
| VARIOUS - SEE ATTACHED3 | 2056 VISTA PKWY WEST PALM BEACH, FL 33411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $729 | $4K | 27.74% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 N STARCREST DR CLEARWATER, FL 33765 | STANDARD INSURANCE COMPANY | $531 | — | $531 | 7.51% |
| STEVEN GRAU3 | 1135 PASADENA AVE S #231 ST PETERSBURG, FL 33708 | STANDARD INSURANCE COMPANY | $329 | — | $329 | 4.65% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 6830 COCHRAN RD SOLON, OH 44139 | STANDARD INSURANCE COMPANY | $66 | — | $66 | 0.93% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 153 | $752K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 153 | $752K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 153 | $752K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $51K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $51K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.