| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $96K | — | $96K | 21.28% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP LLC | 6885 BELFORT OAKS PL STE 210 JACKSONVILLE, FL 32216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $13K | $13K | 15.00% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 | 6885 BELFORT OAKS PL STE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 33.91% |
| TRACY REEVES3 | 16273 SW 9TH STREET PEMBROKE PINES, FL 33027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $795 | — | $795 | 12.23% |
| MIKE DEVAUX3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $382 | — | $382 | 5.88% |
| AMERICAN INS PLUS LLC3 | 8143 BAUTISTA WAY PALM BEACH GARDENS, FL 33418 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $162 | — | $162 | 2.49% |
| BARRY OLFERN AND ASSOC. INC4 | 954 TYLER ST HOLLYWOOD, FL 33019 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $377 | — | $377 | 15.89% |
| TRACY REEVES4 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $231 | — | $231 | 9.73% |
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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $453K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $453K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 122 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $86K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $86K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $86K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 175 | $453K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.