| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 2.05% |
| UMR, INC.3 Filed as: UMR INC. | 115 W WAUSAU AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $686 | $686 | 0.56% |
| OMS INSURANCE GROUP3 Filed as: OMS INSURANCE GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 8.29% |
| OMS OF NORTHWEST FLORIDA INC3 Filed as: OMS OF NORTHWEST FLORIDA INC. | PO BOX 1097 SANTA ROSA BEACH, FL 32459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $366 | $2K | 10.20% |
| OMS INSURANCE GROUP3 Filed as: OMS INSURANCE GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.32% |
| SHAUNET LOUISE PROKUSKI3 | PO BOX 2 LAKELAND, FL 33802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $514 | $1 | $515 | 2.43% |
| JOEY MIGUES3 Filed as: JOEY GRUBBS BENEFITS LLC | 4527 ARGYLE LN TALLAHASSEE, FL 32309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | $118 | $190 | 0.90% |
| DARCIPRETE AND ASSOCIATES INC3 Filed as: DARCIPRETE & ASSOCIATES INC. | 12945 US HWY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | $98 | $168 | 0.79% |
| REUBEN F JACOBS JR3 | 868 LAKE JACKSON CIRCLE APOPKA, FL 32703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.67% |
| DAVID J MCCLELLAN3 Filed as: DAVID B MERKHOFER | 2704 SETTER PL TALLAHASSEE, FL 32303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $7 | $71 | 0.34% |
| WILLIAM RENNARD3 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $6 | $14 | 0.07% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 15.00% |
| MEDICAL GROUP INSURANCE SERVICES3 Filed as: MEDICAL GROUP INSURANCE SERVICES IN | 1849 WEST NORTH TEMPLE SALT LAKE CITY, UT 84116 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.89% |
| KARYN MITRANO ENTERPRISES INC3 Filed as: KARYN MITRANO ENTERPRISES INC. | 2819 EAGLE LAKE DR ORLANDO, FL 32837 | AFLAC | $852 | — | $852 | 8.94% |
| DH2 ENTERPRISES INC3 Filed as: DH2 ENTERPRISES INC. | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $254 | — | $254 | 2.66% |
| JOYCE WEBER ENTERPRISES INC3 Filed as: JOYCE WEBER ENTERPRISES INC. | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $105 | — | $105 | 1.10% |
| J WEBER AND ASSOCIATES INC3 Filed as: J WEBER AND ASSOCIATES INC. | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $86 | — | $86 | 0.90% |
| BRIAN ALLEN BASS3 | 1220 BONNIE LO DR ORLANDO, FL 32809 | AFLAC | $85 | — | $85 | 0.89% |
| TLW VENTURES LLC3 | 614 E HWY 50 338 CLERMONTH, FL 34711 | AFLAC | $77 | — | $77 | 0.81% |
| MKF & ASSOCIATES INC3 Filed as: MKF & ASSOCIATES INC. | 4505 PINE TREE CIR STE 201 BIRMINGHAM, AL 35243 | AFLAC | $63 | — | $63 | 0.66% |
| CHASE DEVOSS ENTERPRISES INC.3 | 603 DELANCEY DR DAVENPORT, FL 33837 | AFLAC | $36 | — | $36 | 0.38% |
| MARY BARE3 Filed as: MARY F BARE | 807 CUMBERLAND CIRCLE MINNEOLA, FL 34715 | AFLAC | $6 | — | $6 | 0.06% |
| DANIEL J LONG3 | 48 EISENTOWN DR LOVETTSVILLE, VA 20180 | AFLAC | $3 | — | $3 | 0.03% |
| LESLIE K KIMBROUGH3 | PO BOX 273488 BOCA RATON, FL 33427 | AFLAC | $1 | — | $1 | 0.01% |
| BRIAN ALLEN BASS3 | 1220 BONNIE LO DR ORLANDO, FL 32809 | AFLAC | $146 | $129 | $275 | 9.14% |
| KARYN MITRANO ENTERPRISES INC3 Filed as: KARYN MITRANO ENTERPRISES INC. | 2819 EAGLE LAKE DR ORLANDO, FL 32837 | AFLAC | $73 | $66 | $139 | 4.62% |
| DANIEL J LONG3 | 48 EISENTOWN DR LOVETTSVILLE, VA 20180 | AFLAC | $38 | $34 | $72 | 2.39% |
| LESLIE K KIMBROUGH3 | PO BOX 273488 BOCA RATON, FL 33427 | AFLAC | $15 | $34 | $49 | 1.63% |
| BARIBEL GUERRA3 | 317 EDGEWOOD CT KISSIMMEE, FL 34759 | AFLAC | — | $5 | $5 | 0.17% |
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 | 120 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 120 | $59K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 120 | $59K |
| Life insurance(5 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 193 | $113K |
| Short-term disability(5 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 193 | $113K |
| Stop-loss / reinsurancereinsurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.