| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1715 NORTH WEST SHORE BOULEVARD SUITE 700 TAMPA, FL 33607 | BLUE CROSS BLUE SHIELD OF FLORIDA | $143K | $0 | $143K | 2.62% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 ROCKY POINT, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $80K | $0 | $80K | 12.62% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $32K | $940 | $33K | 5.15% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $11K | $11K | 1.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 12.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 200 CHARLES EWING BOULEVARD EWING, NJ 08628 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $1K | $0 | $1K | 25.00% |
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 | 429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 374 | $5.5M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 431 | $637K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 611 | $44K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 431 | $637K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 431 | $637K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 374 | $5.5M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 431 | $643K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 611 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.