| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 103 TAMPA, FL 33607 | HEALTH OPTIONS | $19K | — | $19K | 6.03% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 103 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $19K | — | $19K | 6.08% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS | 3401 WEST CYPRESS STREET SUITE 103 TAMPA, FL 33607 | MADISON NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| NORTH AMERICAN BENEFITS COMPANY3 | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 7.43% |
| JOHN M NEWMAN, JR3 Filed as: JOHN M NEWMAN, JR. | 35 PONTE VEDRA COLONY CIRCLE PONTE VEDRA BEACH, FL 32082 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.97% |
| GERALD MORRISON MCGEE JR3 Filed as: GERALD M MCGEE | 3657 RICHMOND STREET JACKSONVILLE, FL 32205 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $495 | $495 | 1.26% |
| ENHANCEDCARE, INC3 Filed as: ENHANCEDCARE, INC. | 1290 UNIVERSITY AVENUE SUITE G ROCHESTER, NY 14607 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | $186 | $186 | 0.47% |
| RONALD WAYNE MOORE3 Filed as: RONALD W MOORE | 3401 WEST CYPRESS STREET SUITE 103 TAMPA, FL 33607 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 14.02% |
| CUSTOM WORKSITE SOLUTIONS3 Filed as: CUSTOM WORKSITE SOULUTIONS LLC | 24909 PIRATE COURT JACKSONVILLE, FL 32224 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.97% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 56 | $622K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $36K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $36K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 105 | $36K |
| Short-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 36 | $39K |
| Long-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 36 | $39K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 56 | $622K |
| Other(2 contracts, 2 carriers) | MADISON NATIONAL LIFE INSURANCE COMPANY | 105 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.