| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DRB BENEFITS GROUP3 | 100 S BOYD ST WINTER GARDEN, FL 347873516 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $44K | — | $44K | 8.55% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DRIVE BRANDON, FL 335114879 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $32K | — | $32K | 6.25% |
| DRB BENEFITS REFINED BENEFITS INC.3 | 1105 NIKKI VIEW DRIVE BRANDON, FL 33511 | DELTA DENTAL INSURANCE COMPANY | $5K | — | $5K | 10.03% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC. | 1105 NIKKI VIEW DRIVE BRANDON, FL 33511 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.62% |
| DAVID BECK3 Filed as: DAVID R BILLSBOROUGH | 100 S BOYD STREET WINTER GARDENS, FL 34787 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC. | 1105 NIKKI VIEW DRIVE BRANDON, FL 335114879 | MONY LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.17% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DRIVE BRANDON, FL 335114879 | COMPBENEFITS COMPANY | $720 | — | $720 | 6.93% |
| DRB BENEFITS GROUP3 Filed as: DRB & ASSOC INC | 57 NORTH LAKEVIEW AVENUE WINTER GARDEN, FL 347872709 | COMPBENEFITS COMPANY | $141 | — | $141 | 1.36% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Contract Administrator; Float revenue; Direct payment from the plan; Non-monetary compensation; Other services; Named fiduciary; Claims processing; Participant communication Service code 12 | — | $231K |
| REFINED BENEFITS DBA SULLIVAN INSURANCE BROKER | Insurance agents and brokers Service code 22 | 1105 NIKKI VIEW DRIVE BRANDON, FL 335114879 | $35K |
| DRB BENEFITS GROUP INSURANCE BROKER | Insurance agents and brokers Service code 22 | 100 S. BOYD ST WINTER HAVEN, FL 34787 | $32K |
| CIGNA | Float revenue; Named fiduciary; Participant communication; Claims processing; Contract Administrator; Direct payment from the plan; Investment management fees paid indirectly by plan; Other services; Non-monetary compensation Service code 12 | — | $0 |
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 | 367 | 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) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL INSURANCE COMPANY | 313 | $53K |
| Vision | COMPBENEFITS COMPANY | 174 | $10K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 421 | $48K |
| Short-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 421 | $48K |
| Long-term disability(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 421 | $48K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 409 | $512K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 421 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 421 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.