Form 5500 · Employee benefit plan · JACKSONVILLE, FL
TIMUQUANA COUNTRY CLUB
The filing calls this plan TIMUQUANA COUNTRY CLUB WELFARE BENEFITS PLAN.
TIMUQUANA COUNTRY CLUB 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, INC. DBA THE BAILEY. Coverage is written through HEALTH OPTIONS and 4 other carriers. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 59-0482540 · plan 501 · plan year 2025, filed Apr 27, 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: death benefits.
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 HEALTH OPTIONS, covers 63 people.
Reported premium across the insured contracts is $748,293, with $42,868 in disclosed broker commissions — about 5.7% of premium.
The most recent policy period ended in September, and the plan year ends September 30. Group contracts typically renew on that annual cycle.
MFB FINANCIAL, INC. DBA THE BAILEY is the broker of record on 2 of the 9 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including HEALTH OPTIONS, BLUE CROSS BLUE SHIELD OF FLORIDA, THE LINCOLN NATIONAL LIFE INSURANCE COMPANY and UNITEDHEALTHCARE INSURANCE COMPANY. HEALTH OPTIONS writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HEALTH OPTIONS | Health | 63 | Oct 1, 2025 | $464,664 | $22,032 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | Health | 15 | Oct 1, 2025 | $167,244 | $6,721 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Dental | 73 | Oct 1, 2025 | $43,135 | $4,314 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Disability | 130 | Oct 1, 2025 | $23,748 | $3,562 |
| UNITEDHEALTHCARE INSURANCE COMPANY | — | 72 | Oct 1, 2025 | $15,430 | $2,028 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 20 | Oct 1, 2025 | $11,592 | $1,739 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 130 | Oct 1, 2025 | $12,619 | $1,262 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Vision | 58 | Oct 1, 2025 | $6,341 | $634 |
| NEW BENEFITS LTD | — | 0 | Oct 1, 2025 | $3,520 | $576 |
Premium and claims on these contracts
HEALTH OPTIONS, contract 60853. For the contract year on this filing, the carrier reported $464,664 in premium earned and $376,099 in claims incurred. Dividing one by the other gives 81%.
BLUE CROSS BLUE SHIELD OF FLORIDA, contract 60853. For the contract year on this filing, the carrier reported $167,244 in premium earned and $132,257 in claims incurred. Dividing one by the other gives 79%.
- HEALTH OPTIONS, contract 60853 reported $88,565 in retention.
- BLUE CROSS BLUE SHIELD OF FLORIDA, contract 60853 reported $34,987 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
How this plan compares
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