| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES, LLC | 236 PONTE VEDRE PARK DR. PONTE VEDRA BEACH, FL 32082 | BLUE CROSS BLUE SHIELD OF FLORIDA | $47K | $0 | $47K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES, LLC | 236 PONTE VEDRA PARK DR PONTE VEDRA BEACH, FL 32082 | BLUE CROSS BLUE SHIELD OF FLORIDA | $27K | $0 | $27K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES LLC | 4233 PABLO PROFESSIONAL COURT STE 200 JACKSONVILLE, FL 32224 | UNION SECURITY INSURANCE COMPANY | $17K | $0 | $17K | 15.06% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA, HERBERT W | 4233 PABLO PROFESSIONAL COURT STE 200 JACKSONVILLE, FL 322243218 | HUMANA INSURANCE COMPANY | $2K | $0 | $2K | 9.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 DENTAL ADMINISTRATOR | Plan Administrator; Claims processing Service code 12 | — | $9K |
| MONTOYA AND ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 4233 PABLO PROFESSIONAL COURT SUITE 201 JACKSONVILLE, FL 32224 | $4K |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 80 | $1.5M |
| Vision | HUMANA INSURANCE COMPANY | 113 | $16K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 181 | $116K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 181 | $116K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 181 | $116K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 50 | $548K |
| Other | UNION SECURITY INSURANCE COMPANY | 181 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.