| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNNY R ADCOCK CLU ASSOC3 Filed as: JOHNNY R ADCOCK, CLU & ASSOC | 311 W FLETCHER AVE TAMPA, FL 336123414 | BLUE CROSS BLUE SHIELD OF FLORIDA | $44K | — | $44K | 3.17% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOY SCOUT BLVD STE 200 TAMPA, FL 336075752 | BLUE CROSS BLUE SHIELD OF FLORIDA | $5K | — | $5K | 0.33% |
| JOHNNY R ADCOCK CLU ASSOC3 Filed as: JOHNNY R ADCOCK, CLU & ASSOC | 311 W FLETCHER AVE TAMPA, FL 336123414 | BLUE CROSS BLUE SHIELD OF FLORIDA | $29K | — | $29K | 3.19% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOY SCOUT BLVD STE 200 TAMPA, FL 336075752 | BLUE CROSS BLUE SHIELD OF FLORIDA | $3K | — | $3K | 0.31% |
| THOMAS W BOSTON3 Filed as: THOMAS FINANCIAL GROUP | 5550 E EXECUTIVE DR STE 500 TAMPA, FL 33609 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 4.10% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.59% |
| THOMAS W BOSTON3 Filed as: THOMAS FINANCIAL GROUP | 5550 W EXECUTIVE DR STE 500 TAMPA, FL 33609 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 3.58% |
| THOMAS W BOSTON3 Filed as: THOMAS FINANCIAL GROUP | 5550 W EXECUTIVE DR STE 500 TAMPA, FL 33609 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $175 | $2K | 9.83% |
| JOHNNY R ADCOCK CLU ASSOC3 | 311 W FLETCHER AVE TAMPA, FL 336123414 | STANDARD INSURANCE COMPANY | $941 | $0 | $941 | 6.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 ASO | Claims processing Service code 12 | — | $14K |
| JOHNNY ADCOCK & ASSOCIATES BROKER | Insurance agents and brokers Service code 22 | 311 W FLETCHER AVE TAMPA, FL 33612 | $7K |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 109 | $1.4M |
| Vision | STANDARD INSURANCE COMPANY | 108 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $148K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 82 | $23K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 215 | $170K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 109 | $2.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.