| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LASSITER WARE3 Filed as: LASSITER-WARE INC | 1317 CITIZENS BLVD LEESBURG, FL 34748 | TOKYO MARINE HCC | $17K | — | $17K | 6.82% |
| DONALD J NELSON JR3 Filed as: DONALD J NELSEN JR | 143 SHIPWATCH CIRCLE TAMPA, FL 33602 | TOKYO MARINE HCC | $2K | — | $2K | 0.68% |
| NELSEN INSURANCE CONSULTING INC3 | 1143 SHIPWATCH CIRCLE TAMPA, FL 33602 | TOKYO MARINE HCC | $0 | $422 | $422 | 0.17% |
| LASSITER WARE3 Filed as: LASSITER-WARE INC | 2701 MAITLAND CENTER PARKWAY MAITLAND, FL 32751 | 5 STAR LIFE INSURANCE COMPANY | $3K | — | $3K | 7.63% |
| LASSITER WARE Filed as: LASSITER-WARE INC | 131 CITIZENS BLVD LEESBURG, FL 34748 | VISION SERVICE PLAN | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Participant communication; Claims processing Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $109K |
| NATIONAL EMPLOYEE BENEFITS ADMINIST EIN 65-0498809 NONE | Contract Administrator Service code 13 | 2010 NW 1050TH AVE PEMBROKE PINES, FL 33028 | $67K |
| LASSITER-WARE INC EIN 59-1258855 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | 2701 MAITLAND CENTER PARKWAY MAITLAND, FL 32751 | $49K |
| KARPUS INVESTMENT MANAGEMENT EIN 16-1290558 NONE | Investment management Service code 28 | 183 SULLYS TRAIL PITTSFORD, NY 14534 | $40K |
| BMJ CPA PLC EIN 45-3414091 NONE | Accounting (including auditing) Service code 10 | 1326 S RIDGEWOOD AVE STE 18 DAYTONA BEACH, FL 32114 | $21K |
| PENSION FUND EVALUATIONS INC EIN 11-2503982 NONE | Investment advisory (plan) Service code 27 | 2450 MIDDLE COUNTRY RD STE 104 CENTEREACH, NY 11720 | $7K |
| LAW OFFICE THOMAS JOHNSON EIN 59-3519587 NONE | Legal Service code 29 | 510 VONDERBURG DR BRANDON, FL 33511 | $6K |
| PNC BANK NA EIN 25-1211909 NONE | Custodial (securities) Service code 19 | 1900 3 9TH STREET 13TH FLOOR MAIL STOP B7-YB-13-15-4 CLEVELAND, OH 44114 | $1K |
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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 7 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 304 | $24K |
| Life insurance | 5 STAR LIFE INSURANCE COMPANY | 206 | $36K |
| Stop-loss / reinsurancereinsurance | TOKYO MARINE HCC | 210 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.