| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SULZBACHER & LANE, INC.3 | 1136 RIVER BIRCH RD. SAINT JOHNS, FL 32259 | FLORIDA BLUE | $19K | — | $19K | 14.67% |
| SULZBACHER & LANE, INC.3 | 1136 RIVER BIRCH RD. SAINT JOHNS, FL 32259 | FLORIDA COMBINED LIFE INSURANCE CO | — | $6K | $6K | 10.12% |
No Schedule C service providers reported on this filing.
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 | 164 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FLORIDA BLUE | 164 | $127K |
| Dental | FLORIDA COMBINED LIFE INSURANCE | 172 | $99K |
| Life insurance | FLORIDA COMBINED LIFE INSURANCE CO | 199 | $62K |
| Long-term disability | FLORIDA COMBINED LIFE INSURANCE CO | 199 | $62K |
| Other | BLUE CROSS BLUE SHIELD OF FL | 164 | $276K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.