No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA EIN 59-2015694 PLAN ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 1798 JACKSONVILLE, TN 322310014 | $479K |
| FLORIDA BLUE INSURANCE PROVIDER | Insurance services Service code 23 | 777 108TH AVENUE NE, SUITE 1200 DALLAS, TX 752660295 | $245K |
| FIRST SERVICE CORP EIN 59-2506423 BENEFIT DEPT | Plan Administrator Service code 14 | — | $228K |
| SUN LIFE ASSURANCE OF CANANDA EIN 38-1082080 PLAN ADMINISTRATOR | Claims processing Service code 12 | ONE SUN LIFE EXECUTIVE PARK WELLESLEY HILLS, MA 024815699 | $45K |
| ROBINSON BUSH CONSULTANT | Consulting fees Service code 70 | 21 PARK LAKE STREET ORLANDO, FL 32803 | $10K |
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 | 1,162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,171 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.