| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $312 | — | $312 | 0.05% |
| ALLYN INCORPORATED3 | 14813 SEMINOLE TRAIL SEMINOLE, FL 33776 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $3K | $174 | $3K | 5.72% |
| SHIRLEY B DRAKE3 | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $1K | $3 | $1K | 1.82% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $929 | — | $929 | 1.55% |
| STAHL & ASSOCIATES INSURANCE INC.3 Filed as: STAHL & ASSOCIATES INSURANCE INC | 110 CARILLON PARKWAY ST. PETERSBURG, FL 33716 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $524 | — | $524 | 0.88% |
| COACH CONCEPTS INC3 | 5655 OAKHURST DRIVE SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $180 | $88 | $268 | 0.45% |
| JOHN R STONER ORG INC3 | 700 CENTRAL AVENUE ST. PETERSBURG, FL 33701 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $237 | — | $237 | 0.40% |
| SUSANNE PAPA3 | 4750 STONEVIEW CIRCLE OLD SMAR, FL 34677 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $197 | — | $197 | 0.33% |
| VONDA DANELLE GOLUB3 | 3330 OVERKLOOK DR NE SAINT PETERSBURG, FL 33703 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $174 | $14 | $188 | 0.31% |
| HEATHER PLANKEY3 | 8390 139TH LANE SEMINOLE, FL 33776 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $185 | — | $185 | 0.31% |
| ANN ASCANI3 | 2809 WINDING TRAIL DR VALRICO, FL 33596 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $103 | — | $103 | 0.17% |
| STEPHANIE SHEPPA3 | 3687 IMPERIAL RIDGE PKWY PALM HARBOR, FL 33716 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $93 | — | $93 | 0.16% |
| THOMAS WALLACE JR3 Filed as: THOMAS WALLACE JR. | PO BOX 3654 PONTE VEDRA, FL 32004 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $74 | — | $74 | 0.12% |
| PAT WILLIAMS INSURANCE CONSULTANTS3 | 18201 GULF BLVD REDINGTON SHORES, FL 33708 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $55 | — | $55 | 0.09% |
| MARK F BARRETT LLC3 | 14141 46TH STREET NORTH CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $24 | $19 | $43 | 0.07% |
| PAUL DONOVAN LLC3 | 1 E. TARPON AVE TARPON SPRINGS, FL 34689 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $42 | — | $42 | 0.07% |
| STEVEN VERMETTE INC3 | 920 SPRING PARK LOOP CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $31 | — | $31 | 0.05% |
| CHERYL ANN GILES3 | 9100 9TH STREET NORTH ST. PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $20 | — | $20 | 0.03% |
| JARRET THOMAS HONAHAN3 | 7 HARBOR OAKS CIRCLE SAFETY HARBOR, FL 34695 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $10 | $3 | $13 | 0.02% |
| TERRY B DRAKE3 | 14141 46TH AVE N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $12 | — | $12 | 0.02% |
| CORPORATE SYNERGIES GROUP LLC3 | 5000 DEARBORN CIR MT LAUREL, NJ 08054 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $10 | — | $10 | 0.02% |
| TULLY AND COMPANY INC3 | 1926 STONE BRIDGE LN MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| WORKSITE AMERICA LLC3 | 14141 46TH STREET NORTH CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| WALTER H MODARELLI3 | 11502 CARROLLWOOD DR TAMPA, FL 33618 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| PAMELA COPLE SMITH3 Filed as: PAMELA SMITH | 128 NORTH ZION STREET WINNSBORO, SC 29180 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DRIVE HAMPSTEAD, NC 28443 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $1 | — | $1 | 0.00% |
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 | 861 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 880 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,424 | $537K |
| Vision | EYEMED | 964 | $45K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 846 | $643K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 846 | $643K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 846 | $643K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 846 | $703K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,424 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.