| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD F SELLERS3 Filed as: RONALD FRANKLIN SELLERS | 300 AVENUE OF THE CHAMPIONS PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 8.83% |
| THOMAS ULINE3 | 7065 CATALINA ISLE DRIVE LAKE WORTH, FL 33467 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.20% |
| MICHAEL MARSHALL3 | 1134 SE 6 CT. DANIA BEACH, FL 33004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $784 | $418 | $1K | 4.70% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $553 | — | $553 | 2.16% |
| DANITZA PENALOZA3 | 541 CARRINGTON LANE WESTON, FL 33326 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $537 | $2 | $539 | 2.11% |
| ANTHONY ACCILIEN3 | 3131 WADDELL AVE WEST PALM BEACH, FL 33411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $504 | $24 | $528 | 2.07% |
| RON SELLERS & ASSOCIATES INC3 | 300 AVENUE OF THE CHAMPIONS PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $448 | — | $448 | 1.75% |
| CYNTHIA ALANE DAVIS3 | 3807 ARTHUR ST HOLLYWOOD, FL 33021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $420 | — | $420 | 1.64% |
| SF INSURANCE SERVICES INC3 | 118 THATCH PALM COVE BOCA RATON, FL 33432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | $22 | $162 | 0.63% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $138 | — | $138 | 0.54% |
| WORKSITE BENEFITS SOLUTION LLC3 | 323 PLEASANT ST. KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | — | $126 | 0.49% |
| CARUSO INSURANCE BENEFITS INC3 | 10872 WILDERNESS COURT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | — | $116 | 0.45% |
| BARBARA C BRENLOVE3 | PO BOX 470701 CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.36% |
| GINAKES & ASSOCIATES LLC3 | 1020 WEST INTERNATIONAL SPEED DAYTONA, FL 32114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | — | $70 | 0.27% |
| ROBERT SHAVERS3 | 1537 COLONY AVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 0.22% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER WEYMOUTH EVANS | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.21% |
| MIS BENEFITS CONSULTANTS INC3 | 2663 RIO DE JANEIRO AVE COOPER CITY, FL 33026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $6 | $46 | 0.18% |
| ADVANCED AGENTS INC3 | 1488 CORONADO RD WESTON, FL 33327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.12% |
| KENNETH A HOLDER3 | 638 LAKEHAVEN CIRCLE ORLANDO, FL 32828 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.09% |
| WORKPLACE BENEFIT SOLUTIONS LLC3 Filed as: WORKPLACE BENEFIT SOLUTION LLC | 80 SHADOW LANE LAKELAND, FL 33813 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.04% |
| WENDY M SILVA3 | 917 WINDMILL GROVE CIRCLE ORLANDO, FL 32828 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.02% |
| BRIAN R CHOWNING | 36241 S GRAYS AIRPORT RD FRUITLAND PARK, FL 34731 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | — | — | $0 | 0.00% |
| ROBERT T. ROSSON JR.3 | 628 PALMETTO DR MIAMI SPRINGS, FL 33166 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 10.79% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 55 | $26K |
| Dental | UNION SECURITY INSURANCE COMPANY | 27 | $18K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 27 | $18K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 27 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 55 | — |
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.