| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RICHARD ALAN SELIGSON3 | PO BOX 970922 BOCA RATON, FL 33497 | AFLAC | $5K | $93 | $5K | 9.25% |
| ROLANDO DARIO RICCIO3 | 101 W CAMINO REAL APT 713 BOCA RATON, FL 33432 | AFLAC | $4K | $22 | $4K | 7.99% |
| HYATT T HADLEY3 | 240 COSTELLO RD WEST PALM BEACH, FL 33405 | AFLAC | $2K | $371 | $2K | 4.35% |
| G SCOTT COOKE3 | 2832 NE 17TH AVE WILTON MANORS, FL 33334 | AFLAC | $1K | $93 | $2K | 2.75% |
| BRENDA LYNN GARRETT3 | 12475 KENTWOOD AVE FORT MYERS, FL 33913 | AFLAC | $85 | — | $85 | 0.15% |
| JOSHUA BUZZARD3 | 6848 HENDRY DR LAKE WORTH, FL 33463 | AFLAC | $59 | — | $59 | 0.11% |
| ALFRED RIETKERK3 | 438 PISGAH PIKE PULASKI, TN 38478 | AFLAC | $14 | — | $14 | 0.03% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DR BOCA RATON, FL 33433 | AFLAC | $3 | — | $3 | 0.01% |
| FRANK ROBERT SOBOCINSKI3 | 2000 PGA BLVD STE 4440 PALM BEACH GARDENS, FL 33408 | AFLAC | $3 | — | $3 | 0.01% |
| JUAN C FERLINI3 | 891 MAYBERRY ML NEW BRAUNFELS, TX 78130 | AFLAC | $3 | — | $3 | 0.01% |
| DEBORAH L JONGES3 | PO BOX 5432 BELLA VISTA, AR 72714 | AFLAC | $3 | — | $3 | 0.01% |
| MELANIE COSTA SILVA3 Filed as: MELANIE B COSTA SILVA | 9315 BOCA GARDENS CIR S APT C BOCA RATON, FL 33496 | AFLAC | $1 | — | $1 | 0.00% |
| BATEMAN GORDON & SANDS3 Filed as: BATEMAN, GORDON & SANDS | 3050 NORTH FEDERAL HIGHWAY SUITE 100 LIGHTHOUSE POINT, FL 33064 | GUARDIAN | $5K | — | $5K | 10.00% |
| NPC FINANCIAL INC.3 | — | GUARDIAN | $200 | — | $200 | 0.38% |
| BATEMAN GORDON & SANDS3 Filed as: BATEMAN, GORDON AND SANDS INC | 3050 N FEDERAL HWY LIGHTHOUSE POINT, FL 33064 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| BATEMAN GORDON & SANDS3 Filed as: BATEMAN, GORDON & SANDS INC | 3050 N FEDERAL HWY LIGHTHOUSE POINT, FL 33064 | TRANSAMERICA LIFE INSURANCE COMPANY | $302 | — | $302 | 9.01% |
| EXCELSIOR BENEFITS LLC3 Filed as: EXCELSIOR BENEFITS | 441 2ND STREET EXCELSIOR, MN 55331 | TRANSAMERICA LIFE INSURANCE COMPANY | $134 | — | $134 | 4.00% |
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 | 166 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MERITAIN HEALTH | 83 | $41K |
| Dental | GUARDIAN | 105 | $53K |
| Vision | GUARDIAN | 105 | $53K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $11K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 78 | $300K |
| Other(3 contracts, 3 carriers) | AFLAC | 166 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.