| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA AND ASSOCIATES LLC3 | 4233 PABLO PROFESSIONAL CT SUITE 200 JACKSONVILLE, FL 322243218 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $56K | $56K | 2.91% |
| BOUCHARD INSURANCE3 | 485 N KELLER ROAD SUITE 450 MAITLAND, FL 327517575 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $18K | $18K | 0.92% |
| PLANNED ADMINISTRATORS, INC.5 | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | BCS INSURANCE COMPANY | $0 | $11K | $11K | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 250 COMMONWEALTH SUITE 107 GREENVILLE, SC 29615 | BCS INSURANCE COMPANY | $4K | $0 | $4K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DR SUITE 101 PONTE VEDRA BEACH, FL 32082 | BCS INSURANCE COMPANY | $4K | $0 | $4K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DRIVE STE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $8K | $3K | $11K | 16.24% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | PO BOX 6090 CLEARWATER, FL 33758 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 3.34% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DRIVE STE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $4K | $1K | $5K | 15.83% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | PO BOX 6090 CLEARWATER, FL 33758 | UNION SECURITY INSURANCE COMPANY | $1K | $0 | $1K | 3.26% |
| PLANNED ADMINISTRATORS, INC.5 | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | BCS INSURANCE COMPANY | $0 | $3K | $3K | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 250 COMMONWEALTH SUITE 107 GREENVILLE, SC 29615 | BCS INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DR. SUITE 101 PONTE VEDRA BEACH, FL 32082 | BCS INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DR STE 101 PONTE VEDRA BEACH, FL 32082 | HUMANA INSURANCE COMPANY | $1K | $0 | $1K | 8.30% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC - KISSIMMEE | 222 CHURCH ST KISSIMMEE, FL 347415057 | HUMANA INSURANCE COMPANY | $239 | $0 | $239 | 1.61% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DR STE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 25.52% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DR STE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 25.94% |
| PLANNED ADMINISTRATORS, INC.5 Filed as: PLANNED ADMINISTRATORS INC | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | 4 EVER LIFE INSURANCE COMPANY | $0 | $999 | $999 | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 250 COMMONWEALTH SUITE 107 GREENVILLE, SC 29615 | 4 EVER LIFE INSURANCE COMPANY | $689 | $0 | $689 | 10.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DR SUITE 101 PONTE VEDRA BEACH, FL 32082 | 4 EVER LIFE INSURANCE COMPANY | $344 | $0 | $344 | 4.99% |
| PLANNED ADMINISTRATORS, INC.5 | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | BCS INSURANCE COMPANY | — | $954 | $954 | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 250 COMMONWEALTH SUITE 107 GREENVILLE, SC 29615 | BCS INSURANCE COMPANY | $658 | — | $658 | 10.00% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DR. SUITE 101 PONTE VEDRA BEACH, FL 32082 | BCS INSURANCE COMPANY | $329 | — | $329 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 CLAIMS PROCESSOR | Other fees; Claims processing Service code 12 | 2323 GRAND BLVD KANSAS CITY, MO 64108 | $10K |
| MONTOYA & ASSOCIATES EIN 27-1357157 AGENT/BROKER | Other commissions; Insurance agents and brokers Service code 22 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | $5K |
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 | 270 | 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) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 270 | $2.0M |
| Dental | BCS INSURANCE COMPANY | 216 | $20K |
| Vision(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 195 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 141 | $75K |
| Short-term disability(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 141 | $75K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 92 | $68K |
| Other(4 contracts) | UNION SECURITY INSURANCE COMPANY | 92 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.