| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | 83 NORTH PARK PLACE BOULEVARD SUITE 101 CLEARWATER, FL 33759 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $47K | $0 | $47K | 13.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS, INC. | 83 NORTH PARK PLACE BOULEVARD SUITE 101 CLEARWATER, FL 33759 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $772 | $19K | 13.46% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 6.03% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.33% |
| GROUP INSURANCE SERVICES INC5 Filed as: GROUP INSURANCE SERVICES, INC. | 1607 NORTH AURORA ROAD, SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | 655 NORTH FRANKLIN STREET SUITE 1900 LAMPA, FL 33602 | METLIFE LEGAL PLANS | $360 | $0 | $360 | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS OF FLORIDA | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $358 | $0 | $358 | 9.94% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT | PO BOX 9201, BUILDING I, SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $181 | $181 | 5.03% |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $352K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $142K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $142K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $142K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $142K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $142K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $352K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 258 | $146K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.