Form 5500 · Employee benefit plan · SPRING HILL, FL
BAY DERMATOLOGY
The filing calls this plan BAY DERMATOLOGY EMPLOYEE BENEFIT PLAN.
BAY DERMATOLOGY of SPRING HILL, FL is a 113-participant health care and social assistance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is ACRISURE LLC WESTERN REGION. Coverage is written through BLUE CROSS BLUE SHIELD OF FLORIDA and 4 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 59-3282073 · plan 501 · plan year 2026, filed Sep 10, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
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 12 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF FLORIDA, covers 35 people.
Reported premium across the insured contracts is $674,905, with $41,870 in disclosed broker commissions — about 6.2% of premium.
The most recent policy period ended in May, and the plan year ends May 31. Group contracts typically renew on that annual cycle.
ACRISURE LLC WESTERN REGION is the broker of record on 2 of the 12 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF FLORIDA, HEALTH OPTIONS, UNITED OF OMAHA LIFE INSURANCE COMPANY and COLONIAL LIFE & ACCIDENT INSURANCE COMPANY. 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 | 35 | Jun 1, 2026 | $216,318 | $10,816 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Disability | 32 | Jun 1, 2026 | $26,404 | $7,030 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2026 | $116,161 | $5,808 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 35 | Jun 1, 2026 | $103,890 | $5,195 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 35 | Jun 1, 2026 | $66,647 | $3,332 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Dental | 44 | Jun 1, 2026 | $31,370 | $3,137 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2026 | $59,273 | $2,964 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2026 | $37,907 | $1,895 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 25 | Jun 1, 2026 | $7,401 | $740 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Vision | 55 | Jun 1, 2026 | $5,597 | $560 |
| SOLSTICE BENEFITS, INC | Dental | 13 | Jun 1, 2026 | $2,242 | $224 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 106 | Jun 1, 2026 | $1,695 | $169 |
Premium and claims on these contracts
BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838. For the contract year on this filing, the carrier reported $216,318 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
HEALTH OPTIONS, contract 90838. For the contract year on this filing, the carrier reported $116,161 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838. For the contract year on this filing, the carrier reported $103,890 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838. For the contract year on this filing, the carrier reported $66,647 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
HEALTH OPTIONS, contract 90838. For the contract year on this filing, the carrier reported $59,273 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
HEALTH OPTIONS, contract 90838. For the contract year on this filing, the carrier reported $37,907 in premium earned and $0 in claims incurred. Dividing one by the other gives 0%.
- BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838 reported $32,967 in retention.
- HEALTH OPTIONS, contract 90838 reported $14,845 in retention.
- BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838 reported $15,833 in retention.
- BLUE CROSS BLUE SHIELD OF FLORIDA, contract 90838 reported $10,156 in retention.
- HEALTH OPTIONS, contract 90838 reported $7,575 in retention.
- HEALTH OPTIONS, contract 90838 reported $4,844 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.
Other plans filed by this employer
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