| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: SUN RISK MANAGEMENT | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 2.64% |
| JAY R SCHREIBMAN3 Filed as: JAY SULLIVAN | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | — | $13K | 2.64% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 2.06% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SUN RISK MANAGEMENT | 120 6TH STREET S ST PETERSBURG, FL 33701 | STANDARD INSURANCE COMPANY | $19K | $0 | $19K | 5.37% |
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | STANDARD INSURANCE COMPANY | $19K | $0 | $19K | 5.37% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOY SCOUT BLVD #200 TAMPA, FL 33607 | STANDARD INSURANCE COMPANY | $12K | $0 | $12K | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 3000 BAYPORT DRIVE SUITE 300 TAMPA, FL 33607 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 1.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $0 | $2K | $2K | 0.50% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SUN RISK MANAGEMENT | 120 6TH STREET S ST PETERSBURG, FL 33701 | STANDARD INSURANCE COMPANY | $11K | $0 | $11K | 5.53% |
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | STANDARD INSURANCE COMPANY | $11K | $0 | $11K | 5.53% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOY SCOUT BLVD #200 TAMPA, FL 33507 | STANDARD INSURANCE COMPANY | $6K | $0 | $6K | 3.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 3000 BAYPORT DRIVE SUITE 300 TAMPA, FL 33607 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 0.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $0 | $932 | $932 | 0.49% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SUN RISK MANAGEMENT | 120 6TH STREET S ST PETERSBURG, FL 33701 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 5.57% |
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 5.57% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOY SCOUT BLVD #200 TAMPA, FL 33607 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 2.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $0 | $485 | $485 | 0.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 3000 BAYPORT DRIVE SUITE 300 TAMPA, FL 33607 | STANDARD INSURANCE COMPANY | $453 | $0 | $453 | 0.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 29848 NETWORK PLACE CHICAGO, IL 606731298 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $845 | $0 | $845 | 6.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC | P O BOX 173086 TAMPA, FL 336721086 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $419 | $0 | $419 | 3.40% |
| M.E. WILSON COMPANY, LLC3 Filed as: M.E. WILSON COMPANY LLC | 300 W PLATT STREET SUITE 200 TAMPA, FL 33606 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $252 | $0 | $252 | 2.05% |
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $234 | $0 | $234 | 1.90% |
| BROKERSUITE INC3 | 124 WASHINGTON STREET, STE 302 FOXBORO, MA 02035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $107 | $0 | $107 | 0.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON LOCKBOX #28852 | PO BOX 28852 NEW YORK, NY 10087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $51 | $51 | 0.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $110K |
| JAY SULLIVAN BROKER | Insurance agents and brokers Service code 22 | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | $3K |
| SUN RISK MANAGEMENT INC BROKER | Insurance agents and brokers Service code 22 | 120 6TH ST S ST PETERSBURG, FL 33701 | $3K |
| BALDWIN KRYSTYN SHERMAN PARTNERS BROKER | Insurance agents and brokers Service code 22 | 4010 W BOY SCOUTS BLVD SUITE 200 TAMPA, FL 33607 | $3K |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 321 | $488K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 321 | $488K |
| Life insurance | STANDARD INSURANCE COMPANY | 673 | $94K |
| Short-term disability | STANDARD INSURANCE COMPANY | 372 | $190K |
| Long-term disability | STANDARD INSURANCE COMPANY | 231 | $359K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 321 | $488K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 321 | $488K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 673 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 673 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.