| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE & PAYROLL RESOURCE GR3 Filed as: THE INSURANCE & PAYROLL RESOURCE | 4301 VINELAND RD., STE E5 ORLANDO, FL 328117371 | HUMANA MEDICAL PLAN | $36K | — | $36K | 6.88% |
| RENAISSANCE BENEFIT ADVISORS3 | 6314 KINGSPOINTE PKWY SUITE 4 ORLANDO, FL 32819 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 10.00% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS INC. | 5426 BAY CENTER DR. SUITE 550 TAMPA, FL 33609 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $169 | — | $169 | 0.20% |
| THE INS & PAYROLL RESOURCE3 Filed as: INS & PAYROLL RESOURCE GROUP OF FL | 4301 VINELAND RD. SUITE E-5 ORLANDO, FL 32811 | SUN LIFE ASSURANCE CO OF CANADA | $3K | — | $3K | 11.31% |
| VIRMELIA RODRIGUEZ3 | 10090 BENNINGTON CHASE DR. ORLANDO, FL 32829 | AFLAC | $3K | $105 | $3K | 12.45% |
| A&M BONURA & ASSC3 | 1882 LAUREL BROOK LOOP VALRICO, FL 33596 | AFLAC | $935 | $14 | $949 | 3.63% |
| CARMEN IRIZARRY3 | 1851 LINDEN AVE, APT 2 GRAND JUNCTION, CO 81503 | AFLAC | $559 | — | $559 | 2.14% |
| TERESA A RUCKER3 Filed as: TERESA RUCKER | 950 S WINTER PARK DR. STE 207 CASSELBERRY, FL 32707 | AFLAC | $378 | — | $378 | 1.45% |
| JOYCE WEBER ENTERPRISES INC3 Filed as: JOYCE WEBBER ENTERPRISES | 13313 FALCON POINTE DR. ORLANDO, FL 32837 | AFLAC | $155 | — | $155 | 0.59% |
| BARNETT I. CHEPENIK3 Filed as: BARNETT CHEPENIK | 1010 ORANGE AVE, WINTER PARK, FL 32789 | AFLAC | $133 | — | $133 | 0.51% |
| JEFFREY B HAWKINS3 Filed as: JEFFREY HAWKINS | PO BOX 36194 MONTROSE, CO 81402 | AFLAC | $109 | — | $109 | 0.42% |
| CLARISSA LYNNE HERRICK3 | 1445 MONTE LAKE DR. VALRICO, FL 33596 | AFLAC | $78 | $22 | $100 | 0.38% |
| CYNTHIA MYER3 | 555 HARBOR SIDE ST. WOODBRIDGE, VA 22191 | AFLAC | $76 | — | $76 | 0.29% |
| MKF & ASSOCIATES INC3 Filed as: MKF & ASSC | 4505 PINE TREE CIR SUITE 201 BIRMINGHAM, AL 35243 | AFLAC | $66 | — | $66 | 0.25% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC BROKER | 927 N MAIN ST SUITE A6 PLEASANTVILLE, NJ 08232 | AFLAC | $45 | $19 | $64 | 0.24% |
| KUKULICA ENTERPRISES INC3 Filed as: KUKULICA ENTERPRISES INC. | 9437 DOUBLE DIAMOND PKWY STE 17 RENO, NV 89521 | AFLAC | $44 | — | $44 | 0.17% |
| ROSWEN ENTERPRISES INC3 Filed as: ROSWEN INC. | 1977 THE OAKS BLVD KISSIMMEE, FL 34746 | AFLAC | $28 | $12 | $40 | 0.15% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | AFLAC | $39 | — | $39 | 0.15% |
| CHEPENIK FINANCIAL SERVICES INC.3 Filed as: CHEPENIK FINANCIAL SERVICES INC | 1010 ORANGE AVE SUITE 170 WINTER PARK, FL 32789 | AFLAC | $33 | — | $33 | 0.13% |
| DANIEL J LONG3 | 1344 ASHTON RD STE 200 HANOVER, MD 21076 | AFLAC | $14 | — | $14 | 0.05% |
| MICHAEL J SHIOMOS3 | 44 MONROE DR. CLEMENTON, NJ 08021 | AFLAC | $6 | $3 | $9 | 0.03% |
| LESLIE K KIMBROUGH3 Filed as: LESLIE KIMBROUGH | P.O. BOX 273488 BOCA RATON, FL 33427 | AFLAC | $6 | — | $6 | 0.02% |
| KEVIN CURTIS3 | 300 E 2ND ST. STE 1320 RENO, NV 89501 | AFLAC | $6 | — | $6 | 0.02% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC BROKER | 13313 FALCON POINTE DR. ORLANDO, FL 32837 | AFLAC | — | — | $0 | 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 | 270 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA MEDICAL PLAN | 67 | $521K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $84K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $84K |
| Life insurance | SUN LIFE ASSURANCE CO OF CANADA | 270 | $27K |
| Short-term disability | SUN LIFE ASSURANCE CO OF CANADA | 270 | $27K |
| Long-term disability | SUN LIFE ASSURANCE CO OF CANADA | 270 | $27K |
| Other | AFLAC | 0 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 270 | — |
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.