| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 2502 NORTH ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | HARTFORD LIFE AND ACCIDENT | $19K | — | $19K | 8.51% |
| WELLS FARGO INSURANCE SERVICES3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 1.59% |
| WELLS FARGO INSURANCE SERVICES3 | 311 PARK PLACE BOULEVARD CLEARWATER, FL 33759 | HARTFORD LIFE AND ACCIDENT | $1K | $168 | $1K | 0.56% |
| WELLS FARGO INSURANCE SERVICES3 | 2502 NORTH ROCKY POINT DRIVE TAMPA, FL 33607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $149 | $3K | 7.22% |
| STEPHANIE SHEPPA3 | 3687 IMPERIAL RIDGE PARKWAY PALM HARBOR, FL 34684 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $336 | $2K | 5.95% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS, INC. | 9500 KOGER BOULEVARD SAINT PETERSBURG, FL 33702 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $45 | $1K | 3.47% |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FL 33761 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $10 | $81 | 0.20% |
| RAY MCMARTIN3 | 8045 TABLE MESA WAY COLORADO SPRINGS, CO 80919 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $39 | $25 | $64 | 0.16% |
| ANTHONY J. BARBER3 | 163 CEDAR STREET BRANFORD, CT 06405 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| GRADY VAUGHN3 | PO BOX 38099 COLORADO SPRINGS, CO 80937 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $2 | $8 | 0.02% |
| WELLS FARGO INSURANCE SERVICES3 | 1700 LINCOLN STREET, 9TH FLOOR DENVER, CO 80203 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 430 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HM LIFE INSURANCE COMPANY | 650 | $37K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 542 | $229K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 542 | $229K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 542 | $277K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 650 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.