| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMS INSURANCE GROUP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $3K | $6K | 11.52% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS INC | 5426 BAY CENTER DR SUITE 550 TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $69 | — | $69 | 0.13% |
| OMS OF NORTHWEST FLORIDA INC3 Filed as: OMS OF NORTHWEST FL | PO BOX 1097 SANTA ROSA BEACH, FL 32459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $744 | $3K | 14.12% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 8.55% |
| NICOLE TOWNSEND VEDDER3 | 3370 LAKE RUN DR TALLAHASSEE, FL 32309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $301 | $141 | $442 | 2.24% |
| JOEY MIGUES3 Filed as: JOEY GRUBBS BENEFITS LLC | 682 VALLEY VIEW ROAD MONTICELLO, FL 32344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $70 | $249 | 1.26% |
| ADVANCED ENROLLMENT SERVICES INC3 | 309 IRONWOODS DR CHAPEL HILL, NC 27516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $204 | $38 | $242 | 1.23% |
| DEBRA LEWIS LINGER3 | 4236 WOODLAWN DR RALEIGH, NC 27616 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $168 | $45 | $213 | 1.08% |
| REUBEN F JACOBS JR3 | 868 LAKE JACKSON CIRCLE APOPKA, FL 32703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.36% |
| BENEFITS COUNT INC3 Filed as: BENEFITS COUNT II INC. | 1401 CHRISTMAS CT RALEIGH, NC 27604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $13 | $41 | 0.21% |
| BARRETT L PATTERSON3 Filed as: BARRETT PATTERSON | PO BOX 10641 RALEIGH, NC 27605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $6 | $19 | 0.10% |
| DARCIPRETE AND ASSOCIATES INC3 Filed as: DARCIPRETE & ASSOCIATES | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.09% |
| JANIE M GREER3 Filed as: JANIE GREER | 124 CHATTERSON DR RALEIGH, NC 27615 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.08% |
| SHAUNET LOUISE PROKUSKI3 | 5000 SE 183RD AVE RD OCKLAWAHA, FL 32179 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.06% |
| DAVID J MCCLELLAN3 Filed as: DAVID B MERKHOFER | 2704 SETTER PL TALLAHASSEE, FL 32303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.03% |
| OMS INSURANCE GROUP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 18.09% |
| KARYN MITRANO ENTERPRISES INC3 Filed as: KARYN MITRANO ENTERPRISES | 2819 EAGLE LAKE DR ORLANDO, FL 32837 | AFLAC | $294 | — | $294 | 3.68% |
| DH2 ENTERPRISES INC3 | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $184 | — | $184 | 2.30% |
| JOYCE WEBER ENTERPRISES INC3 | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $69 | — | $69 | 0.86% |
| J WEBER AND ASSOCIATES INC3 Filed as: J WEBER AND ASSOCIATES | 13313 FALCON POINTE DR ORLANDO, FL 32837 | AFLAC | $54 | — | $54 | 0.68% |
| MKF & ASSOCIATES INC3 Filed as: MKF & ASSOCIATES | 4505 PINE TREE CIR STE 201 BIRMINGHAM, AL 35243 | AFLAC | $41 | — | $41 | 0.51% |
| TLW VENTURES LLC3 | 614 E HIGHWAY 50 338 CLERMONT, FL 34711 | AFLAC | $37 | — | $37 | 0.46% |
| CHASE DEVOSS ENTERPRISES INC.3 | 603 DELANCEY DR DAVENPORT, FL 33837 | AFLAC | $36 | — | $36 | 0.45% |
| BRIAN ALLEN BASS3 | 1220 BONNIE LO DR ORLANDO, FL 32809 | AFLAC | $16 | — | $16 | 0.20% |
| PATRICIA ANNE REILLY3 Filed as: PATRICIA ALMOND | 3964 JOURNEY CT CASSELBERRY, FL 32707 | AFLAC | $4 | — | $4 | 0.05% |
| DOUGLAS J SUCHECKI3 | 3850 VINE STREET SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $3 | — | $3 | 0.04% |
| DANIEL J LONG3 | 1344 ASHTON RD STE 200 HANOVER, MD 21076 | AFLAC | $3 | — | $3 | 0.04% |
| PATRICIA ANNE REILLY3 Filed as: PATRICIA ALMOND | PO BOX 150804 ALTAMONTE SPRINGS, FL 32715 | AFLAC | $2 | — | $2 | 0.03% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHECKI | 3850 VINE STREET SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $2 | — | $2 | 0.03% |
| DEREK DEVANE3 | 3205 JERRY SMITH RD DOVER, FL 33527 | AFLAC | $1 | — | $1 | 0.01% |
| DENA JORDAN3 | 641 HIGUERA ST STE 300 APT 208 SAN LUIS OBISPO, CA 93401 | AFLAC | $1 | — | $1 | 0.01% |
| DAWN T SUCHECKI3 Filed as: DAWN SUCHECKI | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $1 | — | $1 | 0.01% |
| LESLIE K KIMBROUGH3 Filed as: LESLIE KIMBROUGH | PO BOX 273488 BOCA RATON, FL 33427 | AFLAC | $1 | — | $1 | 0.01% |
| SARAH CADY3 | 123 STONE GABLE CIR WINTER SPRINGS, FL 32708 | AFLAC | $1 | — | $1 | 0.01% |
| JENNIE MOORE HAWKINS3 | 3930 S NOVA RD STE 201 PORT ORANGE, FL 32127 | AFLAC | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $92K |
| OMS INSURANCE GROUP EIN 59-3757026 BROKER | Other commissions Service code 55 | PO BOX 2 LAKELAND, FL 33802 | $39K |
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 | 89 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 89 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 89 | $54K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 89 | $54K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 36 | $28K |
| Short-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 36 | $38K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 10 | $11K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 87 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 89 | — |
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.