| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA BROWER & ASSOCIATES3 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $89K | $89K | 5.26% |
| MONTOYA AND ASSOCIATES LLC3 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $16K | $7K | $23K | 19.26% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DRIVE PONTE VEDRA BEACH, FL 32082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $438 | $7K | — |
| ANNALIESE CLARK3 | 1336 HIDEAWAY DRIVE S SAINT JOHNS, FL 32082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $702 | $4K | — |
| JAMES M EANES3 Filed as: JAMES E EANES | 1700 E JACKSON STREET PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $584 | $325 | $909 | — |
| ALYSON MARIE MCMAHON3 | 2127 GRASSY BASIN CT JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $580 | $302 | $882 | — |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 | 1550 HARRINGTON PARK DRIVE JACKSONVILLE, FL 32225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $353 | $440 | $793 | — |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $382 | $55 | $437 | — |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $374 | $62 | $436 | — |
| HEATHER LEA HOOTEN3 | 7111 NE 222ND STREET MELROSE, FL 32666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $175 | $168 | $343 | — |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | $86 | $325 | — |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $216 | $35 | $251 | — |
| ARIADNE DE BASABE-MACHICHE3 | 1825 KINGSFORD DRIVE CORONA, CA 92880 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $31 | $183 | — |
| PATRICIA A DUNCAN3 | 2409 VIA DEL RAY FERNANDINA BEACH, FL 32034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $11 | $163 | — |
| VB SOLUTIONS LLC3 | 7111 NE 222ND STREET MELROSE, FL 32666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $4 | $102 | — |
| WAYNE RIMMER3 | 7454 FARMERS RD PENSACOLA, FL 32526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $78 | $5 | $83 | — |
| D'ARCIPRETE & ASSOCIATES INC3 Filed as: D'ARCIPRETE & ASSOCIATES | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $43 | $72 | — |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $13 | $49 | — |
| MARIA VERONICA JARQUE3 | 8366 VIA SONOMA UNIT E LA JOLLA, CA 92037 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $3 | $39 | — |
| PARRISH J PEACHEE3 Filed as: PARRISH PEACHEE | 201 W. 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $8 | $35 | — |
| CLAUDIA MARABOTO3 | 130 TIERRA MONTANOSA RANCHO, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | — |
| JOHN D EVANGELISTA3 Filed as: JOHN E EVANGELISTA | 29811 SANTA MARGARITA PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $10 | $29 | — |
| COACH CONCEPTS INC3 | 9500 KOGER BLVD ST PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $4 | $28 | — |
| ALICIA MARCUM3 | 611 PONTE VEDRA LAKES BLVD PONTE VEDRA, FL 32082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $9 | $26 | — |
| JAKORP INC3 | 14458 CRESTWOOD AVENUE POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL J MINNEY | P.O. BOX 365 POWAY, CA 92074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 ASO DENTAL | Other fees; Insurance agents and brokers; Claims processing; Non-monetary compensation Service code 12 | — | $13K |
| MONTOYA & ASSOCIATES BROKER | Other commissions; Insurance agents and brokers Service code 22 | 236 PONTE VEDRA PARK DRIVE SUITE 101 PONTE VEDRA BEACH, FL 32082 | $3K |
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 | 187 | 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) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 444 | $1.7M |
| Vision | UNION SECURITY INSURANCE COMPANY | 187 | $122K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 187 | $122K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 187 | $122K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 187 | $122K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 444 | $1.7M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 127 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 444 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.