| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN M KENNEDY3 | 6726 ENGLE LAKE DR LAKELAND, FL 33813 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $36K | $0 | $36K | 6.72% |
| DAVID SHORE3 | 1300 CONCORD TERRACE 5TH FLOOR PLANTATION, FL 33323 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $36K | $0 | $36K | 6.72% |
| JOHN M KENNEDY3 | 6726 ENGLE LAKE DR LAKELAND, FL 33813 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.24% |
| DAVID SHORE3 | 1300 CONCORD TERRACE 5TH FLOOR SUNRISE, FL 33323 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $0 | $1K | 0.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 TPA | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication Service code 12 | — | $245K |
| DAVID SHORE AGENT | Insurance agents and brokers Service code 22 | 1300 CONCORD TERRACE 5TH FLOOR SUNRISE, FL 33323 | $37K |
| JOHN M KENNEDY AGENT | Insurance agents and brokers Service code 22 | 6726 ENGLE LAKE DR LAKELAND, FL 33813 | $37K |
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 | 164 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 158 | $534K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 158 | $534K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 158 | $534K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 164 | $434K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 164 | $434K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.