Form 5500 · Employee benefit plan · SPRING HILL, FL
BAY DERMATOLOGY
The filing calls this plan BAY DERMATOLOGY EMPLOYEE BENEFIT PLAN.
Public Form 5500 records show how BAY DERMATOLOGY of SPRING HILL, FL, a health care and social assistance employer, structures its employee benefits. Its broker of record is ACRISURE LLC WESTERN REGION. Coverage is written through BLUE CROSS BLUE SHIELD OF FLORIDA and 3 other carriers. The plan's most recent policy period ended in May.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 38-1082080 · plan 501 · plan year 2025, filed Feb 6, 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 9 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 $641,825, with $39,879 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 9 contracts; the rest name a different broker or none.
4 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF FLORIDA, HEALTH OPTIONS, SUN LIFE ASSURANCE COMPANY OF CANADA 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, 2025 | $216,318 | $10,816 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Dental, Vision | 25 | Jun 1, 2025 | $47,496 | $7,102 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2025 | $116,161 | $5,808 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | Disability | 22 | Jun 1, 2025 | $23,456 | $3,838 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 35 | Jun 1, 2025 | $66,647 | $3,332 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 35 | Jun 1, 2025 | $66,647 | $3,332 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2025 | $59,273 | $2,964 |
| HEALTH OPTIONS | Health | 27 | Jun 1, 2025 | $37,907 | $1,895 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life | 122 | Jun 1, 2025 | $7,920 | $792 |
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 $66,647 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 $10,156 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.
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