| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS ST STE 100 TAMPA, FL 336073846 | BLUE CROSS BLUE SHIELD OF FLORIDA | $45K | — | $45K | 6.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $10K | — | $10K | 1.84% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $17K | $55K | 19.05% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCS | 3001 WESTOWN PKWY WEST DES MOINES, IA 502661328 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 4.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 4371 LATHAM ST STE 101 RIVERSIDE, CA 925011731 | KAISER FOUNDATION HEALTH PLAN INC | $989 | — | $989 | 0.93% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS | 14850 N SCOTTSDALE RD STE 280 SCOTTSDALE, AL 85254 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $883 | — | $883 | 2.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 2300 CLAYTON ROAD STE 300 CONCORD, CA 94520 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $881 | — | $881 | 2.28% |
| INSURANCE COMPANY OF AMERICA3 Filed as: INSURANCE COMPANY OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 327505069 | COMPBENEFITS | $3K | — | $3K | 10.40% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS | 14850 N SCOTTSDALE RD STE 280 SCOTTSDALE, AZ 85254 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $354 | — | $354 | 3.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 2300 CLAYTON RD STE 300 CONCORD, CA 94520 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $353 | — | $353 | 3.42% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS | 14850 N SCOTTSDALE RD STE 280 SCOTTSDALE, AZ 85254 | INSURANCE COMPANY OF NORTH AMERICA | $588 | — | $588 | 5.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 2300 CLAYTON ROAD STE 300 CONCORD, CA 94520 | INSURANCE COMPANY OF NORTH AMERICA | $586 | — | $586 | 5.70% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCS | 14850 N SCOTTSDALE RD STE 280 SCOTTSDALE, AZ 85254 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $435 | — | $435 | 7.86% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | 2300 CLAYTON ROAD STE 300 CONCORD, CA 94520 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $158 | — | $158 | 2.85% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $530 | $250 | $780 | 14.73% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $257 | $120 | $377 | 14.69% |
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 | 755 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 756 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 63 | $537K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 679 | $292K |
| Vision(2 contracts, 2 carriers) | COMPBENEFITS | 226 | $47K |
| Life insurance(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 679 | $304K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 175 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 175 | $39K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 181 | $860K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 679 | $300K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 679 | — |
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.