| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LL | 3401 WEST CYPRESS STREET SUITE 103 TAMPA, FL 33607 | HEALTH OPTIONS, INC. | $20K | — | $20K | 6.00% |
| RON WAYNE MOORE3 | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $1K | $8K | 17.15% |
| CUSTOM WORKSITE SOLUTIONS3 Filed as: CUSTOM WORKSITE SOULUTIONS, LLC | 2409 PIRATE COURT JACKSONVILLE, FL 32224 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.97% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST SUITE 320 BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $398 | — | $398 | 0.82% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $302 | $4K | 21.88% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $349 | $3K | 22.73% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $101 | $1K | 21.85% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $85 | $1K | 21.57% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $783 | $129 | $912 | 23.30% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $634 | $50 | $684 | 21.59% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $128 | $9 | $137 | 21.31% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH OPTIONS, INC. | 31 | $329K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $48K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $48K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $48K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 22 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 15 | $5K |
| Other(6 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.