Form 5500 · Employee benefit plan · JACKSONVILLE, FL
BORLAND-GROOVER CLINIC, P.A.
The filing calls this plan BORLAND-GROOVER CLINIC, P.A. WELFARE PLAN.
BORLAND-GROOVER CLINIC, P.A. of JACKSONVILLE, FL files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is MFB FINANCIAL DBA THE BAILEY GROUP. Coverage is written through HCC LIFE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in April.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 59-1784470 · plan 508 · plan year 2025, filed Oct 17, 2025
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151 other employer plans in Florida have policy years ending in April. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
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
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
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 8 insured contracts covering dental, vision, life, disability and stop-loss; the largest, with HCC LIFE INSURANCE COMPANY, covers 565 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $823,341 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium across the insured contracts is $2,146,079, with $203,734 in disclosed broker commissions — about 9.5% of premium.
The most recent policy period ended in April, and the plan year ends April 30. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| STANDARD INSURANCE COMPANY | Disability | 715 | May 1, 2025 | $391,413 | $52,541 |
| STANDARD INSURANCE COMPANY | Dental | 531 | May 1, 2025 | $364,055 | $43,987 |
| STANDARD INSURANCE COMPANY | Life | 719 | May 1, 2025 | $151,480 | $31,610 |
| CONTINENTAL AMERICAN INSURANCE COMPANY | Disability | 232 | May 1, 2025 | $133,539 | $29,712 |
| STANDARD INSURANCE COMPANY | Disability | 270 | May 1, 2025 | $184,786 | $25,308 |
| STANDARD INSURANCE COMPANY | Vision | 460 | May 1, 2025 | $65,145 | $16,162 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | — | 85 | May 1, 2025 | $32,320 | $4,414 |
| HCC LIFE INSURANCE COMPANY | Stop-loss | 565 | May 1, 2025 | $823,341 | $0 |
Premium and claims on these contracts
STANDARD INSURANCE COMPANY, contract 144829. For the contract year on this filing, the carrier reported $350,379 in premium earned and $333,900 in claims incurred. Dividing one by the other gives 95%.
STANDARD INSURANCE COMPANY, contract 144829. For the contract year on this filing, the carrier reported $349,809 in premium earned and $261,988 in claims incurred. Dividing one by the other gives 75%.
STANDARD INSURANCE COMPANY, contract 144829. For the contract year on this filing, the carrier reported $140,169 in premium earned and $51,604 in claims incurred. Dividing one by the other gives 37%.
STANDARD INSURANCE COMPANY, contract 144829. For the contract year on this filing, the carrier reported $173,150 in premium earned and $144,240 in claims incurred. Dividing one by the other gives 83%.
STANDARD INSURANCE COMPANY, contract 144829. For the contract year on this filing, the carrier reported $65,145 in premium earned and $43,834 in claims incurred. Dividing one by the other gives 67%.
- STANDARD INSURANCE COMPANY, contract 144829 reported $176,787 in retention.
- STANDARD INSURANCE COMPANY, contract 144829 reported $101,585 in retention.
- STANDARD INSURANCE COMPANY, contract 144829 reported $88,568 in retention.
- STANDARD INSURANCE COMPANY, contract 144829 reported $81,870 in retention.
- STANDARD INSURANCE COMPANY, contract 144829 reported $30,925 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
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