| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $54K | — | $54K | 14.32% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC. | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | HARTFORD LIFE AND ACCIDENT | $13K | — | $13K | 15.49% |
| CENTRO BENEFITS RESEARCH LLC3 | 200 GALLERIA PKWY SUITE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 3.70% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $0 | $6K | 9.87% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC. | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | METROPOLITAN LIFE INSURANCE COMPANY | $933 | $0 | $933 | 10.32% |
| BARRY OLFERN AND ASSOC. INC4 | 954 TYLER ST HOLLYWOOD, FL 33019 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $204 | — | $204 | 5.59% |
| TRACY REEVES4 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $90 | — | $90 | 2.47% |
| SUPERIOR LIFE SOLUTIONS, INC.4 | 1607 WRENWOOD WAY MOUNT JULIET, TN 37122 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $21 | — | $21 | 0.58% |
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 | 82 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 89 | $379K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 74 | $65K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 104 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 92 | $82K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 92 | $82K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 92 | $82K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 92 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.