| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL INC. | 1200 PLANTATION ISLAND DR S SUITE 210 ST. AUGUSTINE, FL 32086 | BLUE CROSS BLUE SHIELD OF FLORIDA | $27K | — | $27K | 4.00% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL INC. | 1200 PLANTATINO ISLAND DR. S SUITE 210 SAINT AUGUSTINE, FL 32080 | HEALTH OPTIONS, INC. | $7K | — | $7K | 4.00% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL INC. | 1200 PLANTATION ISLAND DR. S. SUITE 210 ST. AUGUSTINE, FL 32086 | HUMANA INSURANCE COMPANY | $3K | $1K | $4K | 15.99% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL INC. | 1200 PLANTATIN ISLAND DR. S SUITE 210 SAINT AUGUSTINE, FL 32080 | COMPBENEFITS COMPANY | $2K | $516 | $2K | 18.49% |
| MFB FINANCIAL INC3 Filed as: MFB FINANCIAL INC. | 1200 PLANTATION ISLAND DR. S SUITE 210 ST. AUGUSTINE, FL 32086 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $142 | — | $142 | 23.43% |
| MATT CASTO4 | 1700 WHITFIELD RD. SE EAST GRAND RAPIDS, MI 49506 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $138 | — | $138 | 22.77% |
| CHARLES B ZITSMAN4 Filed as: CHARLES ZITSMAN | 3521 KINGS RD. ST. AUGUSTINE, FL 32086 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $74 | — | $74 | 12.21% |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 114 | $871K |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 153 | $39K |
| Vision | HUMANA INSURANCE COMPANY | 153 | $28K |
| Other | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 2 | $606 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.