| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $23K | $0 | $23K | 3.18% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: SUN RISK MANAGEMENT | 120 6TH STREET S ST PETERSBURG, FL 33701 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $23K | $0 | $23K | 3.18% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4010 W BOYSCOUT BLVD SUITE 200 TAMPA, FL 33607 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | $0 | $15K | 2.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29848 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9 | $0 | $9 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29848 NETWORK PLACE CHICAGO, IL 60673 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.72% |
| M.E. WILSON COMPANY, LLC3 Filed as: M.E WILSON COMPANY LLC | 300 W PL SUITE 200 TAMPA, FL 33606 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.63% |
| JAY F. SULLIVAN3 Filed as: JAY F SULLIVAN | 160 GOULD S SUITE 310 NEEDHAM, MA 02494 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC | PO BOX 173086 TAMPA, FL 33672 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.87% |
| BROKERSUITE INC3 | 124 WASHINGTON STREET SUITE 302 FOXBORO, MA 02035 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $244 | $0 | $244 | 0.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | PO BOX 28852 NEW YORK, NC 10087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $232 | $232 | 0.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $198K |
| JAY F SULLIVAN AGENT | Insurance agents and brokers Service code 22 | 160 GOULD STREET SUITE 310 NEEDHAM, MA 02494 | $8K |
| SUN RISK MANAGEMENT INC AGENT | Insurance agents and brokers Service code 22 | 120 6TH STREET S ST PETERSBURG, FL 33701 | $8K |
| BALDWIN KRYSTYN SHERMAN PARTNERS AGENT | Insurance agents and brokers Service code 22 | 4010 W BOYSCOUT BLVD SUITE 200 TAMPA, FL 33607 | $7K |
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 | 506 | 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) | 506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 604 | $720K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 604 | $720K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 604 | $720K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 604 | $720K |
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 100 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 604 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.