| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL DEVAUX3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | AETNA LIFE INSURANCE COMPANY | $8K | — | $8K | 0.18% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | — | $21K | 3.17% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $35K | — | $35K | 6.73% |
| UNITED BENEFIT ADVISORS OF FLORIDA3 | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | $4K | $24K | 15.91% |
| TRACY REEVES3 Filed as: TRACY LYNN REEVES | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.89% |
| KEYSTONE BENEFIT GROUP3 | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | EYEMED VISION CARE | $14K | — | $14K | 13.51% |
| BARRY OLFERN AND ASSOC. INC4 | 954 TYLER ST HOLLYWOOD, FL 33019 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $3K | — | $3K | 5.96% |
| TRACY REEVES4 | 16273 SW 9TH ST PEMBROKE PINES, FL 33027 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $3K | — | $3K | 5.96% |
| THOMPSON SUCCESS PARTNERS, INC.4 Filed as: THOMPSON SUCCESS PARTNERS INC | 2776 GEARY ST MATLACHA, FL 33993 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 1.94% |
| NEW BIZ LLC4 | 4102 COLUMNS DR SE MARIETTA, GA 30067 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $657 | — | $657 | 1.19% |
| ITEM III TRUST U/W DAVID A SAVULA4 | 480 RIVERHILL DR ATLANTA, GA 30328 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $327 | — | $327 | 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 | $195 | — | $195 | 0.35% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PL SUITE 210 JACKSONVILLE, FL 32216 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | — | $800 | $800 | 4.32% |
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 | 1,587 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,632 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,097 | $4.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,097 | $4.4M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,097 | $4.5M |
| Life insurance(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,097 | $5.6M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 789 | $666K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 789 | $1.2M |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 1,097 | $4.4M |
| Other(5 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,097 | $5.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,097 | — |
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.