| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL DEVAUX3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | AETNA LIFE INSURANCE COMPANY | $39K | — | $39K | 0.92% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | $18K | $45K | 4.38% |
| KEYSTONE BENEFITS GROUP, INC.(GREEN3 Filed as: KEYSTONE BENEFITS GROUP | 6885 BELFORT OAKS PLACE JACKSONVILLE, FL 32216 | EYEMED | $13K | — | $13K | 9.10% |
| TRACY REEVES3 | 16273 SW 9TH STREET PEMBROKE PINES, FL 33027 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27K | — | $27K | 27.50% |
| MIKE DEVAUX3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 7.69% |
| AMERICAN INSURANCE PLUS LLC3 | 8131 BAUTISTA WAY PALM BEACH GARDEN, FL 33418 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 5.53% |
| TRACY REEVES3 Filed as: TRACY LYNN REEVES | 16273 SW 9TH STREET PEMBROKE PINES, FL 33027 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 7.89% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.38% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | MONUMENTAL LIFE INSURANCE COMPANY | $2K | — | $2K | 5.77% |
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 | 1,912 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,941 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,416 | $4.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,416 | $4.3M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,416 | $4.4M |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,416 | $5.3M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 992 | $1.0M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 992 | $1.0M |
| Other(4 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,416 | $5.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,416 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.