| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORT OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | CIGNA | $9K | $0 | $9K | 5.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3427 NORFOLK, VA 23514 | CIGNA | $7K | $0 | $7K | 4.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN LEXINGTON PARK, MD 20653 | CIGNA | $633 | $0 | $633 | 0.40% |
| KEYSTONE BENEFIT GROUP3 Filed as: KEYSTONE BENEFIT GROUP, LLC | 6885 BELFORD OAKS PLACE SUITE 210 JACKSONVILLE, FL 32216 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 7.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 2.77% |
| TRACY L REEVES3 | 16273 SW 9TH STREET PEMBROKE PINES, FL 33027 | AFLAC | $3K | $143 | $3K | 9.79% |
| KEYSTONE BENEFIT GROUP3 | 10175 FORTUNE PARKWAY UNIT 303 JACKSONVILLE, FL 32256 | AFLAC | $2K | $0 | $2K | 5.84% |
| SUWAT ASSAWAMATIYANONT3 | 8171 HAMPTON WOOD DRIVE BOCA RATON, FL 33433 | AFLAC | $649 | $8 | $657 | 1.88% |
| THOMAS ASSOCIATES LLC3 Filed as: THOMAS ASSOC, LLC AND VARIOUS AGENT | 2801 SCENIC MEADOW STREET WALDROF, MD 20603 | AFLAC | $485 | $0 | $485 | 1.39% |
| JILL HALVERSON3 Filed as: JILL ANNE HALVERSON | 3359 GARDENS EAST DRIVE APARTMENT A PALM BEACH GARDENS, FL 33410 | AFLAC | $308 | $0 | $308 | 0.88% |
| TOM KOCH3 Filed as: TOM L KOCH | 1800 NE 48TH COURT FORT LAUDERDALE, FL 33308 | AFLAC | $119 | $0 | $119 | 0.34% |
| KAREN A DEVINE3 | 21071 LARKSPUR COURT LEONARDTOWN, MD 20650 | AFLAC | $77 | $0 | $77 | 0.22% |
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 | 189 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA | 189 | $159K |
| Vision | CIGNA | 189 | $159K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 189 | $132K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 189 | $132K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 189 | $132K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 189 | $167K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.