| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | 1715 N WESTSHORE BLVD SUITE 700 TAMPA, FL 33607 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $67K | — | $67K | 17.67% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL HERNDON & ASSOC | 91 LAKE MORTON DRIVE LAKELAND, FL 338015346 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | — | $46K | 12.34% |
| USI INSURANCE SERVICES LLC3 | 1715 N WESTSHORE BLVD SUITE 700 TAMPA, FL 33607 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $9K | $25K | 8.77% |
| STAHL HERNDON & ASSOCIATES3 | 91 LAKE MORTON DRIVE LAKELAND, FL 33801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 4.94% |
| BENETEK CORPORATION3 | 4275 WEST SAND LAKE ROAD ORLANDO, FL 32819 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $698 | — | $698 | 0.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS ADMIN | Direct payment from the plan; Float revenue; Other services; Contract Administrator; Participant communication; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $37K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 HLTH PROVIDER EAP | Named fiduciary; Other services; Claims processing; Direct payment from the plan; Non-monetary compensation; Other commissions; Participant communication; Float revenue; Contract Administrator Service code 12 | — | $6K |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 244 | $377K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 191 | $286K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.