| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | BLUE CROSS BLUE SHIELD OF FLORIDA | $37K | — | $37K | 5.00% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | HEALTH OPTIONS | $19K | — | $19K | 5.00% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BCH, FL 334421723 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 5.48% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 752511800 | HUMANA INSURANCE COMPANY | — | $621 | $621 | 0.78% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $1K | — | $1K | 10.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $155 | — | $155 | 1.22% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $917 | — | $917 | 9.82% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $114 | — | $114 | 1.22% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | TELADOC, INC | $2K | — | $2K | 25.08% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $839 | — | $839 | 9.52% |
| FLORIDA BLUE3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $107 | — | $107 | 1.21% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $321 | — | $321 | 5.22% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $75 | — | $75 | 1.22% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33422 | USABLE LIFE | $475 | — | $475 | 10.45% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 J JACKSONVILLE, FL 32246 | USABLE LIFE | $55 | — | $55 | 1.21% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $241 | — | $241 | 13.58% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $22 | — | $22 | 1.24% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $59 | — | $59 | 10.03% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $7 | — | $7 | 1.19% |
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 | 252 | 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) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 82 | $1.1M |
| Dental | HUMANA INSURANCE COMPANY | 235 | $79K |
| Vision | HUMANA INSURANCE COMPANY | 235 | $79K |
| Life insurance(3 contracts) | USABLE LIFE | 252 | $20K |
| Short-term disability | USABLE LIFE | 37 | $9K |
| Long-term disability | USABLE LIFE | 20 | $13K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 82 | $1.1M |
| Other(5 contracts, 2 carriers) | TELADOC, INC | 252 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.