| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 2536 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $7K | $0 | $7K | 4.05% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATT T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $4K | $4K | 2.23% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 4370 LA JOLLA VILLAGE DR SAN DIEGO, CA 92122 | AETNA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 9.67% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $9 | $2K | 4.67% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | $924 | $0 | $924 | 2.31% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $506 | $0 | $506 | 1.27% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 211 SOUTH 23RD ST PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 3.86% |
| SANTA CRUZ CHARLOTTE R3 | 718 DUNBAR AVE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $618 | $0 | $618 | 2.34% |
| NIMNITHT INS SVCS LLC3 | 1550 CASSAT AVE JACKSONVILLE, FL 32210 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $605 | $0 | $605 | 2.29% |
| KEELER & ASSOCIATES3 Filed as: KEELER & ASSOCIASTES | 211 SOUTH 23RD ST PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $524 | $0 | $524 | 1.99% |
| VELOCITY BENEFITS3 | 113 SILKY SULLIVAN WAY CANTON, GA 30115 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $162 | $0 | $162 | 0.61% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 32750 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $103 | $0 | $103 | 0.39% |
| SANTA CRUZ CHARLOTTE R3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $265 | $0 | $265 | 2.95% |
| KEELER & ASSOCIATES3 Filed as: KEELER SHAWN J | 211 SOUTH 23RD ST PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $173 | $0 | $173 | 1.92% |
| NIMNICHT INS SVCS LLC3 | 1550 CASSAT AVE JACKSONVILLE, FL 32210 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $164 | $0 | $164 | 1.82% |
| KEELER & ASSOCIATES3 | 211 SOUTH 23RD ST PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $89 | $0 | $89 | 0.99% |
| VELOCITY BENEFITS3 | 113 SILKY SULLIVAN WAY CANTON, GA 30115 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $64 | $0 | $64 | 0.71% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE RD 434 LONGWOOD, FL 32750 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $40 | $0 | $40 | 0.44% |
| FLORIDA AUTOMOBILE DEALERS ASSOC3 | ATTN T SMITH EXEC VP TALLAHASSEE, FL 32301 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $90 | $90 | 1.14% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 244 | $133K |
| Vision | AETNA LIFE INSURANCE COMPANY | 244 | $133K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $51K |
| Short-term disability(3 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 113 | $222K |
| Long-term disability(3 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 113 | $222K |
| Other(5 contracts, 3 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 417 | $300K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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.