| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REBSAMEN INSURANCE INC3 | REGIONS INSURANCE DEPT 268 PO BOX 11407 BIRMINGHAM, AL 35246 | AETNA LIFE INSURANCE CO. | $10K | — | $10K | 2.37% |
| REGIONS INSURANCE INC3 | DEPT #268 - PO BOX 11407 BIRMINGHAM, AL 35246 | NATIONAL GUARDIAN LIFE | $3K | — | $3K | 6.09% |
| REGIONS INSURANCE INC3 | DEPT# 268 - PO BOX 11407 BIRMINGHAM, AL 35246 | NATIONAL GUARDIAN LIFE | $729 | — | $729 | 10.00% |
| RUBY ROBB3 | 3216 THACKERY WAY PLANT CITY, FL 33566 | AFLAC | $1K | — | $1K | — |
| ELEANOR M BREZNAY3 | 919 KEITH LN AUBURNDALE, FL 33823 | AFLAC | $223 | — | $223 | — |
| LOCKWOOD INSURANCE3 | 1426 E IRON EAGLE DR EAGLE, ID 83616 | AFLAC | $130 | — | $130 | — |
| TRACEY H BOURDON3 | 4866 MANDOLIN CT WINTER HAVEN, FL 33884 | AFLAC | $97 | — | $97 | — |
| JESSICA W MCKENZIE3 | 324 ODELL SHOALS RD WALHALLA, SC 29691 | AFLAC | $63 | — | $63 | — |
| TERESA M CAMPBELL3 Filed as: TERESA CAMPBELL | 210 WT WYATT RD EASLEY, SC 29642 | AFLAC | $45 | — | $45 | — |
| ANNA ELIZABET RECCHIA3 Filed as: ANNA RECCHIA | 7 S ABERDEEN ST APT 2C CHICAGO, IL 60607 | AFLAC | $42 | — | $42 | — |
| MARK A LINSNER3 Filed as: MARK LINSNER | 153 BLANDING BLVD STE 3 ORANGE PARK, FL 32073 | AFLAC | $39 | — | $39 | — |
| JOHN H VRATSINAS3 Filed as: JOHN VRATSINAS | 1142 W MADISON ST UNIT 305 CHICAGO, IL 60607 | AFLAC | $33 | — | $33 | — |
| DONALD P KREDENSOR3 Filed as: DONALD KREDENSOR | 1112 RIVER WALK DR SIMPSONVILLE, SC 29681 | AFLAC | $23 | — | $23 | — |
| ROGERS BENEFIT GROUP INC3 Filed as: DEBORAH L ROGERS, INC | 11124 FOSTER CARRIAGE RD LITHIA, FL 33547 | AFLAC | $18 | — | $18 | — |
| SUSAN BRIMHALL3 | 3921 CAPE SAN BLAS RD PORT SAINT JOE, FL 32456 | AFLAC | $15 | — | $15 | — |
| JOHN TYLER3 | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $12 | — | $12 | — |
| JMG BUSINESS PARTNERS LLC3 | 102 S EVERS ST STE 101 PLANT CITY, FL 33563 | AFLAC | $12 | — | $12 | — |
| MARK A HARRELL3 Filed as: MARK HARRELL | 11121 S EMERALD AVE APT 2 CHICAGO, IL 60628 | AFLAC | $11 | — | $11 | — |
| PRATT & ASSOCIATES INC3 | 177 SAVONA WAY NORTH VENICE, FL 34275 | AFLAC | $8 | — | $8 | — |
| GARY L RICKETTS INC3 | PO BOX 576 SEFFNER, FL 33583 | AFLAC | $8 | — | $8 | — |
| URSULA HUNT3 | 5705 45TH ST E LOT 208 BRADENTON, FL 34203 | AFLAC | $6 | — | $6 | — |
| HEARTLAND BENEFITS INC3 | 233 EAST CENTER AVE SEBRING, FL 33870 | AFLAC | $5 | — | $5 | — |
| BARTLEIN AND ASSOC INC3 | 5577 BROADCAST COURT SARASOTA, FL 34240 | AFLAC | $5 | — | $5 | — |
| JAN HAMBY ALDAMUY3 Filed as: JAN ALDAMUY | 16203 MUIRFIELD DR ODESSA, FL 33556 | AFLAC | $5 | — | $5 | — |
| GRAVES INC3 | 5336 CAPTAINS CT NEW PORT RICHEY, FL 34652 | AFLAC | $4 | — | $4 | — |
| J W GRIMES INC3 Filed as: JW GRIMES INC | 6165 WATERFORD RD COLUMBUS, GA 31904 | AFLAC | $4 | — | $4 | — |
| GROUP PLANS INC3 | PO BOX 5164 LAKELAND, FL 33807 | AFLAC | $3 | — | $3 | — |
| JENNIFER HOLLAND3 | 3122 W NORTH ST TAMPA, FL 33614 | AFLAC | $2 | — | $2 | — |
| HARRY E HUNT JR3 Filed as: HARRY HUNT JR | 5707 45TH ST E LOT 208 BRADENTON, FL 34203 | AFLAC | $2 | — | $2 | — |
| JOEL M LUSTGARTEN3 Filed as: JOEL LUSTGARTEN | 3000 N OCEAN DR APT 20B RIVIERA BEACH, FL 33404 | AFLAC | $2 | — | $2 | — |
| JACK RICE INSURANCE LLC3 | 13080 BELCHER RD S STE H LARGO, FL 33773 | AFLAC | $2 | — | $2 | — |
| JOHN J GRUND3 Filed as: JOHN GRUND | 4119 24TH AVE WEST BRADENTON, FL 34205 | AFLAC | $2 | — | $2 | — |
| POPPELL INSURANCE, INC.3 Filed as: POPPELL INS INC | 503 W MARTIN LUTHER KING JR BLVD PLANT CITY, FL 33563 | AFLAC | $2 | — | $2 | — |
| JANINE FOX3 | 5303 HARMONY MILLS WEST COHOES, NY 12047 | AFLAC | $1 | — | $1 | — |
| FRANCIS V CRUZ3 Filed as: FRANCIS CRUZ | 19115 LIVINGSTON AVE LUTZ, FL 33559 | AFLAC | $1 | — | $1 | — |
| DAYTON LLC3 | 324 OLD WOOD DR COLUMBIA, SC 29212 | AFLAC | $1 | — | $1 | — |
| GARY W JOHNSON3 Filed as: GARY JOHNSON | 123 CENTER PARK DR STE 102 KNOXVILLE, TN 37922 | AFLAC | $1 | — | $1 | — |
| HORACE R WEAVER III3 Filed as: HORACE WEAVER III | 106 FOUNTAIN DR SLIDELL, LA 70458 | AFLAC | $1 | — | $1 | — |
| MARY REBECCA WEATHERLY3 Filed as: MARY WEATHERLY | 1934 E LEEWYNN DRIVE SARASOTA, FL 34240 | AFLAC | $1 | — | $1 | — |
| JEFFREY GLENN YARISH3 Filed as: JEFFREY YARISH | 16122 ARMISTEAD LN ODESSA, FL 33556 | AFLAC | $1 | — | $1 | — |
| GARY L GAULE3 Filed as: GARY GAULE | 4415 HARRISON ST STE 515 HILLSIDE, IL 60162 | AFLAC | $0 | — | $0 | — |
| MARK C LEE3 Filed as: MARK LEE | 1444 SOUTH 17TH ST WILMINGTON, NC 28401 | AFLAC | $0 | — | $0 | — |
| KIMBERLY DIAN CROCKETT3 Filed as: KIMBERLY CROCKETT | 732 SILVER SANDS DR CORDOVA, TN 38018 | AFLAC | $0 | — | $0 | — |
| JENNIFER B MOREHEAD3 Filed as: JENNIFER MOREHEAD | 13412 WHITBY RD HUDSON, FL 34667 | AFLAC | $0 | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REBSAMEN INSURANCE INC EIN 71-0621654 BROKER | Insurance agents and brokers Service code 22 | REGIONS INSURANCE DEPT 268 PO BOX 11407 BIRMINGHAM, AL 35246 | $44K |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 163 | $425K |
| Dental | NATIONAL GUARDIAN LIFE | 128 | $47K |
| Vision | NATIONAL GUARDIAN LIFE | 132 | $7K |
| Life insurance | AETNA LIFE INSURANCE CO. | 163 | $425K |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 163 | $425K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 163 | $425K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 163 | $425K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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."
No prospect flags tripped on this filing.