| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $21K | — | $21K | 4.92% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.75% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | — | $22K | 13.33% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $887 | $19K | 15.75% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $9K | — | $9K | 9.74% |
| BARRY OLFERN AND ASSOC. INC4 | 954 TYLER ST HOLLYWOOD, FL 33019 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 6.00% |
| TRACY REEVES4 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 6.00% |
| THOMPSON SUCCESS PARTNERS, INC.4 Filed as: THOMPSON SUCCESS PARTNERS INC | 2776 GEARY ST MATLACHA, FL 33993 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $709 | — | $709 | 1.94% |
| NEW BIZ LLC4 | 4102 COLUMNS DR SE MARIETTA, GA 30067 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $431 | — | $431 | 1.18% |
| ITEM III TRUST U/W DAVID A SAVULA4 Filed as: ITEM III TRUS U/W DAVID A SAVULA | 480 RIVERHILL DR ATLANTA, GA 30328 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $216 | — | $216 | 0.59% |
| CAROL PURDY FIELDS4 Filed as: CAROL CLINTON SMITH MARITAL TRUST | 3317 WAUWINET WAY NORMAN, OK 73071 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $128 | — | $128 | 0.35% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $564 | — | $564 | 10.00% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS GROUP LLC | 325 N KIRKWOOD RD STE 300 KIRKWOOD, MT 63122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $89 | $89 | 1.58% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | $171 | — | $171 | 4.56% |
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 | 1,194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 720 | $2.7M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 720 | $2.9M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 685 | $95K |
| Life insurance(3 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 639 | $930K |
| Short-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 639 | $562K |
| Long-term disability(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 639 | $811K |
| Other(6 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 720 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 720 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.