| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREEN LINE BENEFITS LLC--WILLIAM R3 | 999 VANDERBILT BEACH RD STE 606 NAPLES, FL 34108 | DELTA DENTAL OF MINNESOTA | $9K | $0 | $9K | 8.38% |
| GREEN LINE BENEFITS3 | STE 501 5150 TAMIAMI TRAIL N NAPLES, FL 34103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 9.97% |
| GREEN LINE BENEFITS3 | STE 501 5150 TAMIAMI TRAIL N NAPLES, FL 34103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 15.00% |
| THOMAS W BOSTON3 Filed as: THOMAS FINANCIAL GROUP, INC. | 5550 W EXECUTIVE DR STE 500 TAMPA, FL 33609 | UNUM INSURANCE COMPANY | $670 | $0 | $670 | 3.85% |
| M FINANCIAL HOLDINGS INC3 | SUITE 900 1125 NW COUCH ST PORTLAND, OR 97209 | UNUM INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| GREEN LINE BENEFITS3 | STE 501 5150 TAMIAMI TRAIL N NAPLES, FL 34103 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $0 | $1K | 12.00% |
| GREEN LINE BENEFITS3 | STE 501 5150 TAMIAMI TRAIL N NAPLES, FL 34103 | UNUM INSURANCE COMPANY | $776 | $0 | $776 | 7.00% |
| GREEN LINE BENEFITS3 | STE 501 5150 TAMIAMI TRAIL N NAPLES, FL 34103 | UNUM INSURANCE COMPANY | $541 | $0 | $541 | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Claims processing; Non-monetary compensation; Contract Administrator; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $3K |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 223 | $106K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 123 | $12K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $100K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $77K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $77K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 137 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.