| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WASHINGTON | 1501 4TH AVE SUITE 2400 SEATTLE, WA 98101 | AETNA LIFE INSURANCE COMPANY | $23K | — | $23K | 4.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WA, INC. | 2106 PACIFIC AVE SUITE 501 TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $204 | $2K | 19.95% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRATORS | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $204 | — | $204 | 2.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | 2106 PACIFIC AVE SUITE 501 TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $393 | $79 | $472 | 12.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRATORS | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $79 | — | $79 | 2.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | 2106 PACIFRIC AVE SUITE 501 TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $550 | $27 | $577 | 15.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 777 108TH AVE NE SUITE 200 BELLEVUE, WA 98004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $145 | — | $145 | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $12 | $12 | 0.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF WA, INC. | 2106 PACIFIC AVE SUITE 501 TACOMA, WA 98402 | VISION SERVICE PLAN | $358 | — | $358 | 10.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WA, INC. | 2106 PACIFIC AVE SUITE 501 TACOMA, WA 98402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $144 | $29 | $173 | 12.01% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRATORS | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29 | — | $29 | 2.01% |
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 | 111 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 75 | $485K |
| Dental | AETNA LIFE INSURANCE COMPANY | 75 | $485K |
| Vision | VISION SERVICE PLAN | 29 | $4K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 72 | $1K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $4K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 27 | $4K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 75 | $485K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 111 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.