| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF FLORIDA | $31K | $0 | $31K | 5.00% |
| ACCURATE INSURANCE SOLUTIONS INC3 Filed as: ACCURATE INSURANCE SOLUTIONS | 3802 EHRLICH ROAD, SUITE 312 TAMPA, FL 33624 | BLUE CROSS BLUE SHIELD OF FLORIDA | $14K | $0 | $14K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | $0 | $14K | 8.24% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $6K | $6K | 3.57% |
| ACCURATE INSURANCE SOLUTIONS INC3 Filed as: ACCURATE INSURANCE SOLUTIONS, INC. | 16019 NORTH FLORIDA AVENUE LUTZ, FL 33549 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 2.24% |
| MICHAEL R REBER3 Filed as: MICHAEL ROY REBER | 20101 HERON CROSSING DRIVE TAMPA, FL 33647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $4K | $5K | 23.61% |
| USI INSURANCE SERVICES LLC3 | 2502 NORTH ROCKY POINT DRIVE TAMPA, FL 33607 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $26 | $4K | 17.83% |
| RUBEN ROSA3 | 9785 MAGNOLIA BLOSSOM DRIVE TAMPA, FL 33626 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $339 | $3K | $4K | 15.63% |
| MATTHEW HAND3 | 8508 PARROTS LANDING DRIVE TAMPA, FL 33647 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $516 | $3K | 11.60% |
| GEORGE XANTHAKY3 Filed as: GEORGE SANTIAGO | 14628 TRAILS EDGE BOULEVARD ODESSA, FL 33556 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $745 | $2K | 9.89% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS, INC. AND AGENTS | 5655 OAKHURST DRIVE SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $408 | $2K | 7.08% |
| FRANCISCO JAVIER RUIZ3 | 10102 COURTNEY OAKS CIRCLE TAMPA, FL 33619 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $187 | $1K | 5.61% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 84 | $914K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $165K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $165K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $165K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $165K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $165K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 84 | $914K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.