| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 951 YAMATO ROAD, SUITE 200W BOCA RATON, FL 33431 | HEALTH OPTIONS | $3K | — | $3K | 1.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 951 YAMATO ROAD, SUITE 200W BOCA RATON, FL 33431 | BLUE CROSS BLUE SHIELD OF FLORIDA | $3K | — | $3K | 2.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 951 YAMATO ROAD, SUITE 200W BOCA RATON, FL 33431 | FLORIDA COMBINED LIFE | $840 | — | $840 | 2.87% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES | 301 INTERNATIONAL CIR. HUNT VALLEY, MD 21030 | FLORIDA COMBINED LIFE | $566 | — | $566 | 1.93% |
| FLORIDA BLUE3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $76 | — | $76 | 0.26% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 17.77% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $742 | — | $742 | 5.12% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $247 | $247 | 1.71% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $779 | $2K | 15.97% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $667 | — | $667 | 5.80% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $222 | $222 | 1.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $685 | $2K | 16.48% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $532 | — | $532 | 5.16% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $177 | $177 | 1.72% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 951 YAMATO ROAD, SUITE 200W BOCA RATON, FL 33431 | FLORIDA COMBINED LIFE | $232 | — | $232 | 3.04% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES | 301 INTERNATIONAL CIR. HUNT VALLEY, MD 21030 | FLORIDA COMBINED LIFE | $149 | — | $149 | 1.95% |
| FLORIDA BLUE3 | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $33 | — | $33 | 0.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $454 | $490 | $944 | 13.58% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MA 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $245 | — | $245 | 3.52% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $121 | $121 | 1.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE | $338 | $607 | $945 | 24.14% |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 78 | $269K |
| Dental(2 contracts) | FLORIDA COMBINED LIFE | 64 | $37K |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 95 | $4K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $14K |
| Prescription drug | HEALTH OPTIONS | 78 | $155K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.