| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 6.77% |
| HARDEN & ASSOCIATES3 | 201 RIVERSIDE AVE STE 1000 JACKSONVILLE, FL 32202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $16 | $7K | 2.63% |
| ASSUREX3 Filed as: ASSUREX AGENCY INC | 175 SOUTH THIRD ST SUITE 800 COLUMBUS, GA 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $158 | $0 | $158 | 0.06% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 5.68% |
| HARDEN & ASSOCIATES3 | 501 RIVERSIDE AVE SUITE 1000 JACKSONVILLE, FL 32202 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 1.82% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $210 | $210 | 0.11% |
| HARDEN & ASSOCIATES3 | 501 RIVERSIDE AVE SUITE 1000 JACKSONVILLE, FL 32202 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 2.00% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 1.43% |
| HARDEN & ASSOCIATES3 | 501 RIVERSIDE AVE SUITE 1000 JACKSONVILLE, FL 32202 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 3.14% |
| ALLTRUST INSURANCE3 | 2965 ALT 19 N PALM HARBOR, FL 34683 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 1.53% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVE, SUTIE 1500 CLEVELAND, OH 44114 | COMPBENEFITS | $3K | $0 | $3K | 8.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA EIN 59-2015694 PLAN SPONSOR | Contract Administrator Service code 13 | — | $261K |
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 | 589 | 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) | 589 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 0 | $417K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 397 | $284K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 589 | $194K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 397 | $367K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 397 | $359K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 0 | $417K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF FLORIDA | 0 | $417K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 589 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 589 | — |
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.