| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 5.48% |
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INS INC | 101 STARCREST DRIVE CLEARWATER, FL 33765 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 240 SOUTH PINEAPPLE AVENUE SUITE 301 SARASOTA, FL 34236 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.88% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 220 SOUTH RIDGEWOOD AVENUE SUITE 500 DAYTONA BEACH, FL 32114 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $161 | — | $161 | 0.12% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA INC | 1780 NORTH KROME AVENUE HOMESTEAD, FL 33030 | TRANSAMERICA LIFE INSURANCE COMPAMY | $3K | — | $3K | 8.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | TRANSAMERICA LIFE INSURANCE COMPAMY | $1K | — | $1K | 3.98% |
| ROGER BOUCHARD INSURANCE INC3 | 101 NORTH STARCREST DRIVE CLEARWATER, FL 33765 | TRANSAMERICA LIFE INSURANCE COMPAMY | $9 | — | $9 | 0.03% |
| EXCELSIOR BENEFITS LLC3 | 23505 SMITHTOWN ROAD SUITE 200 EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPAMY | $4 | — | $4 | 0.01% |
| MARIA C ORTIZ3 | 7400 SOUTHWEST 50TH TERRACE SUITE 300 MIAMI, FL 33155 | AFLAC | $186 | — | $186 | 3.39% |
| MARTA M SASTRE3 | PO BOX 140127 CORAL GABLES, FL 33114 | AFLAC | $77 | — | $77 | 1.40% |
| LISETTE M HERNANDEZ3 | 10121 NORTHGOLDEN ELM DRIVE ESTERO, FL 33928 | AFLAC | $55 | — | $55 | 1.00% |
| EILEEN SANCHEZ MEDINA3 | 6100 SOUTHWEST 44TH TERRACE MIAMI, FL 33155 | AFLAC | $48 | — | $48 | 0.88% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JAMES GRAYDON BROWN | 2522 OWENS LANDING TRL NW KENNESAW, GA 30152 | AFLAC | $24 | — | $24 | 0.44% |
| ALFRED RIETKERK3 | 3120 NORTHEAST 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $3 | — | $3 | 0.05% |
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 | 154 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $132K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $132K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $132K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $132K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $167K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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.