| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SVS INC | 1717 N SAM HOUSTON PKWY STE 115 HOUSTON, TX 770380000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $38K | — | $38K | 14.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SV | 3301 NORTHERN DR SUITE 301 AUSTION, TX 78731 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 13.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SVS INC | 1717 N SAM HOUSTON PKWY STE 115 HOUSTON, TX 770380000 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.86% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SVS INC | 1717 N SAM HOUSTON PKWY STE 115 HOUSTON, TX 770380000 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $623 | $3K | 19.32% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SVS INC | 1717 N SAM HOUSTON PKWY STE 115 HOUSTON, TX 77038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $950 | $3K | 21.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN LONE STAR INS SVS INC | 1717 N SAM HOUSTON PKWY STE 115 HOUSTON, TX 77038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $513 | $160 | $673 | 19.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Float revenue; Named fiduciary; Contract Administrator; Non-monetary compensation; Claims processing; Other services; Direct payment from the plan Service code 12 | CARECORE DBA EVICORE 400 BUCKWALTER PLACE BLVD BLUFFON, SC 29910 | $5K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary Service code 12 | AMERICAN SPECIALTY HEALTH 10221 WATERIDGE CIRCLE, SUITE 201 SAN DIEGO, CA 92121 | $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 | 167 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $273K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $69K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $69K |
| Life insurance(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 167 | $92K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 82 | $14K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 34 | $14K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 167 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.