| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE COMPANY OF AMERICA3 Filed as: INSURANCE COMPANY OF AMERICA INC. | 4915 W. CYPRESS ST TAMPA, FL 33607 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 7.20% |
| SUSAN GONZALEZ3 | 4406 OLD SAYBROOK AVE TAMPA, FL 33624 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | — | $1K | 1.78% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC. | 4915 W. CYPRESS ST, STE 100 TAMPA, FL 33607 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 12.98% |
| SUSAN R. GONZALEZ3 | 4406 OLD SAYBROOK AVE TAMPA, FL 33624 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 2.46% |
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 | 207 | 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) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 152 | $80K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $79K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $79K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $79K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 206 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.