| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | HEALTH OPTIONS | $29K | — | $29K | 4.61% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 850 CONCOURSE PKWY S STE 200 MAITLAND, FL 327516145 | HEALTH OPTIONS | $9K | — | $9K | 1.40% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 327162207 | BLUE CROSS BLUE SHIELD OF FLORIDA | $20K | — | $20K | 4.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 850 CONCOURSE PKWY S STE 200 MAITLAND, FL 327516145 | BLUE CROSS BLUE SHIELD OF FLORIDA | $7K | — | $7K | 1.60% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 9.53% |
| SARAH WEYMOUTH3 | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $576 | $2K | 2.22% |
| WORKSITE BENEFITS SOLUTION LLC3 | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $782 | $2K | 2.15% |
| FAITH CRYSTAL TAYLOR3 | 431 AUSTRALIAN WAY DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $6 | $1K | 1.41% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS CT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $304 | $1K | 1.35% |
| BARBARA C BRENLOVE3 | PO BOX 470701 KISSIMMEE, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.27% |
| BIANCA NAVARRO3 | 4082 NORTH 10TH STREET HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $107 | $1K | 1.09% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $421 | $201 | $622 | 0.59% |
| RAY BLAZAK3 | 22419 E PLYMOUTH CIR AURORA, CO 80016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $510 | $32 | $542 | 0.52% |
| WORKPLACE BENEFIT SOLUTIONS LLC3 | 80 SHADOW LANE LAKELAND, FL 33813 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $503 | — | $503 | 0.48% |
| KENNETH A HOLDER3 | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $347 | $49 | $396 | 0.38% |
| CHRISTIAN STOUT3 | 7575 E 29TH PL DENVER, CO 80238 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $186 | $288 | 0.27% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER LEE WEYMOUTH | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | $95 | $260 | 0.25% |
| TANYA AUSTIN VALENTE3 | 3267 HAWKS NEST DRIVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $260 | — | $260 | 0.25% |
| DEBRA DAIGLE AMOEDO3 | 12750 GRECO DRIVE ORLANDO, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $168 | $3 | $171 | 0.16% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.13% |
| TJM CONSULTING LLC3 | 8061 SOUTH KENDALL BLVD LITTLETON, CO 80128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.10% |
| CARUSO INSURANCE BENEFITS INC3 | 10872 WILDERNESS CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.05% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE STE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | — | $50 | 0.05% |
| GUIOMAR NAVARRO3 | 3528 WARBLER WAY KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.02% |
| ROBERT SHAVERS3 | 13716 HAWKEYE DR ORLANDO, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| COLLETTE G BOISVERT3 | 349 CENTRAL STREET MANCHESTER, NH 03103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| VOLUNTARY SOLUTIONS INC3 | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.01% |
| DEANNA BOUFFORD3 | 406 MAHOGANY RIDGE DR DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| MICHAEL EDWARD LEES3 | 40 GARFIELD DENVER, CO 80206 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| RAY MCMARTIN3 | 8045 TABLE MESA WAY COLORADO SPRINGS, CO 80919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| EDWARD JOSEPH CORBETT3 | 6185 S PARIS STREET GREENWOOD VILLAGE, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DANIEL CORY3 | 300 E 17TH AVE DENVER, CO 80203 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| JULIE FEDER1 | 5532 S QUEMOY CIRCLE AURORA, CO 80015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $626 | $2K | 3.82% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVE MAITLAND OFFICE RALEIGH, NC 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $849 | — | $849 | 1.35% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC. | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 13.66% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVE MAITLAND OFFICE RALEIGH, NC 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $622 | — | $622 | 2.39% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $982 | $3K | 13.62% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVE MAITLAND OFFICE RALEIGH, NC 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $623 | — | $623 | 2.81% |
| INSURANCE OF AMERICA3 Filed as: INSURANCE OF AMERICA, INC. | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $809 | $2K | 12.95% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $483 | $2K | 13.29% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVE RALEIGH, NC 27612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $307 | — | $307 | 2.24% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $910 | — | $910 | 8.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 333 SOUTH GARLAND AVENUE SUITE 1600 ORLANDO, FL 32801 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $218 | — | $218 | 1.93% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 65 | $1.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $63K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 100 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 144 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 38 | $22K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 65 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 144 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.