Form 5500 · Employee benefit plan · PENSACOLA, FL
ADSYNC TECHNOLOGIES, INC.
The filing calls this plan ADSYNC HEALTH & WELFARE BENEFIT PLAN.
Public Form 5500 records show how ADSYNC TECHNOLOGIES, INC. of PENSACOLA, FL, a professional services employer, structures its employee benefits. Its broker of record is KEYSTONE BENEFIT GROUP LLC. Coverage is written through BLUE CROSS BLUE SHIELD OF FLORIDA and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-1431567 · plan 501 · plan year 2024, filed Jul 17, 2025
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How this plan is funded
Both, as reported
The medical insurance contracts on the filing cover fewer than half the people in the plan, so the rest is paid another way.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 4 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF FLORIDA, covers 40 people.
Reported premium across the insured contracts is $555,698, with $32,833 in disclosed broker commissions — about 5.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
KEYSTONE BENEFIT GROUP LLC is the broker of record on 2 of the 4 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF FLORIDA, THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, USABLE LIFE and SUN LIFE ASSURANCE COMPANY OF CANADA. BLUE CROSS BLUE SHIELD OF FLORIDA writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 40 | Jan 1, 2025 | $476,507 | $18,723 |
| USABLE LIFE | Life, Disability | 92 | Jan 1, 2025 | $26,530 | $6,259 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Dental, Vision | 72 | Jan 1, 2025 | $40,657 | $4,886 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Disability | 35 | Jan 1, 2025 | $12,004 | $2,965 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF FLORIDA, contract A5661. For the contract year on this filing, the carrier reported $476,507 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
- BLUE CROSS BLUE SHIELD OF FLORIDA, contract A5661 reported $86,820 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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