| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 9.87% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | PO BOX 6090 CLEARWATER, FL 34618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | PO BOX 6090 CLEARWATER, FL 34618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | PO BOX 6090 CLEARWATER, FL 34618 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $718 | — | $718 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROGER BOUCHARD INSURANCE NONE | Insurance agents and brokers Service code 22 | PO BOX 6090 CLEARWATER, FL 34618 | $52K |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 NONE | Participant communication; Named fiduciary; Direct payment from the plan; Other services; Non-monetary compensation; Float revenue; Claims processing; Contract Administrator Service code 12 | — | $41K |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 135 | $91K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 135 | $91K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $21K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $34K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.