| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 300 N BEACH ST DAYTONA BEACH, FL 32114 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $24K | $0 | $24K | 2.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV INC | 8337 W. SUNSET RD STE 150 LAS VEGAS, NV 89113 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $17K | $0 | $17K | 1.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | 1120 ASSET LOOP SUITE 104 MANASSAS, VA 20109 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | — | $446 | $446 | 0.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 5727 FORT LAUDERDALE, FL 33010 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.31% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN INSURANCE SERVICES | 400 E KALISTE SALOOM RD STE 1100 LAFAYETTE, LA 70508 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV INC | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 5.07% |
| BROWN AND BROWN OF FLORIDA, INC. Filed as: BROWN & BROWN INSURANCE SERVICES | 400 E KALISTE SALOOM RD STE 1100 LAFAYETTE, LA 70508 | ANTHEM LIFE INSURANCE COMPANY | $252 | — | $252 | 4.54% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 5727 FORT LAUDERDALE, FL 33010 | ANTHEM LIFE INSURANCE COMPANY | $252 | — | $252 | 4.54% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV INC | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | ANTHEM LIFE INSURANCE COMPANY | $210 | — | $210 | 3.78% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | PO BOX 5727 FORT LAUDERDALE, FL 33010 | ANTHEM LIFE INSURANCE COMPANY | $217 | — | $217 | 4.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 400 E KALISTE SALOOM RD STE 1100 LAFAYETTE, LA 70508 | ANTHEM LIFE INSURANCE COMPANY | $217 | — | $217 | 4.13% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NV INC | 2300 W SAHARA AVE STE 800 LAS VEGAS, NV 89102 | ANTHEM LIFE INSURANCE COMPANY | $210 | — | $210 | 3.99% |
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 | 203 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 170 | $1.2M |
| Dental | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 170 | $1.2M |
| Vision | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 170 | $1.2M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 203 | $23K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 9 | $5K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 10 | $6K |
| Other | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 170 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.