| 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 | $40K | — | $40K | 5.00% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | HEALTH OPTIONS | $21K | — | $21K | 5.00% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BCH, FL 334421723 | HUMANA INSURANCE COMPANY | $5K | — | $5K | 4.14% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 752511800 | HUMANA INSURANCE COMPANY | — | $957 | $957 | 0.81% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $916 | — | $916 | 5.48% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $43 | — | $43 | 0.26% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $908 | — | $908 | 5.69% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $41 | — | $41 | 0.26% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | USABLE LIFE | $618 | — | $618 | 5.67% |
| FLORIDA BLUE3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $28 | — | $28 | 0.26% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 334421723 | TELADOC, INC | $2K | — | $2K | 26.09% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33422 | USABLE LIFE | $260 | — | $260 | 4.28% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 J JACKSONVILLE, FL 32246 | USABLE LIFE | $15 | — | $15 | 0.25% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $158 | — | $158 | 2.84% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $14 | — | $14 | 0.25% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $50 | — | $50 | 4.85% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $3 | — | $3 | 0.29% |
| FIDELITY INSURANCE AGENCY INC3 | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | USABLE LIFE | $35 | — | $35 | 4.03% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $2 | — | $2 | 0.23% |
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 | 260 | 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) | 260 | 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 | 93 | $1.2M |
| Dental | HUMANA INSURANCE COMPANY | 297 | $118K |
| Vision | HUMANA INSURANCE COMPANY | 297 | $118K |
| Life insurance(3 contracts) | USABLE LIFE | 260 | $23K |
| Short-term disability | USABLE LIFE | 40 | $17K |
| Long-term disability | USABLE LIFE | 19 | $16K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 93 | $1.2M |
| Other(5 contracts, 2 carriers) | USABLE LIFE | 260 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 297 | — |
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.