| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOSEPH SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | SUN LIFE ASSURANCE COMPANY OF CANADA | $45K | — | $45K | 10.00% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | — | $24K | 15.00% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 335114879 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | — | $9K | 9.86% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL LIFE & ACC - SEE LIST | — | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $673 | $9K | 21.84% |
| REFINED BENEFITS DBA SULLIVAN3 Filed as: REFINED BENEFITS INC | 1105 NIKKI VIEW DRIVE BRANDON, FL 33511 | UNION SECURITY INSURANCE COMPANY | $3K | — | $3K | 10.02% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33551 | MERITAIN HEALTH | $9K | — | $9K | 29.36% |
| REFINED BENEFITS DBA SULLIVAN3 | 1105 NIKKI VIEW DR BRANDON, FL 33551 | ADVANTICA INSURANCE COMPANY | $2K | — | $2K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIM PROCESSOR | Claims processing Service code 12 | — | $105K |
| REFINED BENEFITS INC EIN 59-3652048 BROKER | Other commissions Service code 55 | 1105 NIKKI VIEW DR BRANDON, FL 33511 | $24K |
| HUMANA EIN 27-1649291 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $9K |
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 | 227 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 176 | $480K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 516 | $120K |
| Vision | ADVANTICA INSURANCE COMPANY | 377 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $159K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $159K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $159K |
| Prescription drug | SUN LIFE ASSURANCE COMPANY OF CANADA | 176 | $451K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 176 | $451K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 516 | — |
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.