| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REFINED BENEFITS DBA SULLIVAN3 | 10672 BLOOMINGDALE AVENUE SUITE 102 RIVERVIEW, FL 33578 | SUN LIFE ASSURANCE COMPANY OF CANADA | $50K | $8K | $58K | 16.10% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DR BRANDEN, FL 33511 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $5K | $18K | 14.09% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 10672 BLOOMINGDALE AVE STE 102 RIVERVIEW, FL 33578 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $6K | $20K | 17.44% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $350 | $9K | 12.14% |
| THE JOSEPH AGENCY INC.4 | 314 WICKHAM CT LONGWOOD, CT 32779 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | — | $1K | 10.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REFINED BENEFITS EIN 59-3652048 BROKER | Insurance agents and brokers Service code 22 | — | $115K |
| MERITAIN HEALTH EIN 16-1264154 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $73K |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $126K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 203 | $126K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $112K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $112K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $112K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 182 | $363K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 305 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.