| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 245 SUMMER ST BOSTON, MA 02110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $84K | $9K | $93K | 16.82% |
| FIDELITY HEALTH INSURANCE SERVICES3 Filed as: FIDELITY HEALTH INSURANCE SERV. LLC | 200 SEAPORT BLVD MAIL ZONE V2B BOSTON, MA 02210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $39K | — | $39K | 7.85% |
| DSM FINANCIAL LLC3 | 950 PENINSULA CORPORATE CIRCLE SUITE 1005 BOCA RATON, FL 33487 | AMERICAN PUBLIC LIFE INSURANCE COMPANY | $3K | — | $3K | 12.97% |
| THE SOUTHERN REGION LLC3 | 7313 MERCHANT COURT SARASOTA, FL 34240 | AMERICAN PUBLIC LIFE INSURANCE COMPANY | $1K | — | $1K | 4.42% |
| MARIA ORTIZ3 | 7400 SW 50TH TERRRACE, SUITE 300 MIAMI, FL 33155 | AFLAC | $106 | — | $106 | 3.14% |
| LOURDES M. ALDEREGUIA3 | 9808 SW 94TH TERRACE MIAMI, FL 33176 | AFLAC | $82 | — | $82 | 2.43% |
| MARTA M SASTRE3 Filed as: MARTA M. SASTRE | PO BOX 140127 CORAL GABLES, FL 33114 | AFLAC | $49 | — | $49 | 1.45% |
| FRANCISCO T. DENAVARRA3 | 5835 SW 81ST STREET SOUTH MIAMI, FL 33143 | AFLAC | $29 | — | $29 | 0.86% |
| MJ INSURANCE3 Filed as: C HUDSON AND VARIOUS AGENTS | 701 BRICKELL AVENUE, 9TH FLOOR MIAMI, FL 33131 | AFLAC | $21 | — | $21 | 0.62% |
| ALFRED RIETKERK3 | 3120 NE 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $10 | — | $10 | 0.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JAMES BROWN | 2522 OWENS LANDING TRAIL NW KENNESAW, GA 30152 | AFLAC | $6 | — | $6 | 0.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 EAP PLAN ADMIN | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $9K |
| CIGNA | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $0 |
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 | 176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 246 | $518K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $550K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $550K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $550K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $550K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $550K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 176 | $554K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.