| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PINETREE CAPITAL LLC3 | 5511 UNIVERSITY DRIVE SUITE 102 CORAL SPRINGS, FL 33442 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $21K | — | $21K | 9.52% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC. | 500 JIM MORAN BLVD #107 DEERFIELD BEACH, FL 33442 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC. | 500 JIM MORAN BLVD #107 DEERFIELD BEACH, FL 33442 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY | 500 JIM MORAN BLVD DEERFIELD BEACH, FL 33442 | VISION SERVICE PLAN | $640 | — | $640 | 8.17% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $39 | — | $39 | 0.50% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY | 500 JIM MORAN BLVD #107 DEERFIELD BEACH, FL 33442 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $269 | — | $269 | 5.00% |
| FIDELITY INSURANCE AGENCY INC3 Filed as: FIDELITY INSURANCE AGENCY, INC. | 500 JIM MORAN BLVD #107 DEERFIELD BEACH, FL 33442 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $505 | — | $505 | 14.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMIN FEES | Contract Administrator; Direct payment from the plan; Non-monetary compensation; Named fiduciary; Participant communication; Float revenue; Claims processing; Other services Service code 12 | — | $25K |
| FLORIDA HEALTH ADMINISTRATORS, INC. SERVICE FEES | Contract Administrator; Insurance agents and brokers Service code 13 | 6861 SW 196TH AVE SUITE 402 FORT LAUDERDALE, FL 33332 | $2K |
| DENTEMAX LLC SERVICE FEES | Insurance agents and brokers; Contract Administrator Service code 13 | 300 E RANDOLPH ST CHICAGO, IL 60601 | $820 |
| FIDELITY INSURANCE SERVICE FEES | Insurance agents and brokers; Contract Administrator Service code 13 | 500 JIM MORAN BLVD #7 DEERFIELD BEACH, FL 33442 | $394 |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 77 | $223K |
| Vision | VISION SERVICE PLAN | 39 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $10K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.