| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $53K | — | $53K | 13.77% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $926 | $19K | 15.75% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 10.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $318 | $7K | 15.75% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $241 | — | $241 | 3.21% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $102 | — | $102 | 1.36% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DRIVE BRANDEN, FL 33511 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $214 | $1 | $215 | 2.94% |
| SMITH, THOMAS, CHRISTOPHER3 | 2928 FOSTER CREIGHTON DRIVE NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $77 | — | $77 | 1.05% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 140 | $386K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 150 | $121K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 150 | $121K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $166K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $123K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 158 | $123K |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 36 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.