| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $138K | $138K | 3.83% |
| 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 | $8K | $4K | $11K | 5.85% |
| 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 | $10K | $2K | $12K | 12.53% |
| WEB BENEFITS DESIGN CORPORATION5 | 4725 W SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.79% |
| 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 | $9K | $3K | $12K | 12.69% |
| WEB BENEFITS DESIGN CORPORATION5 | 4725 W SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.79% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $876 | $4K | 12.17% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $661 | $2K | 5.35% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $585 | $181 | $766 | 2.30% |
| KENNETH A HOLDER3 | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $487 | $14 | $501 | 1.50% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS CT. KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $404 | $67 | $471 | 1.41% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $358 | $104 | $462 | 1.39% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $283 | $171 | $454 | 1.36% |
| SAMANTHA C CORTELAZZO-ABBATE3 | 1283 TWIN RIVERS BLVD OVIEDO, FL 32766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $287 | — | $287 | 0.86% |
| CARUSO INSURANCE BENEFITS INC3 | 10872 WILDERNESS CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $149 | $5 | $154 | 0.46% |
| ROBERT SHAVERS3 | 1537 COLONY AVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.39% |
| MARGIE LEE SHELDON3 | 325 EUNICE RD. LAKELAND, FL 33803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $32 | $129 | 0.39% |
| WYNCIN P MARTIN3 | 214 BALBOA DR KISSIMMEE, FL 34758 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | $7 | $126 | 0.38% |
| SABRINA S RAMOS3 | 13750 W. COLONIAL DR WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.11% |
| BARBARA C BRENLOVE3 | PO BOX 470701 CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $1 | $28 | 0.08% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE STE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| COLLETTE G BOISVERT3 | 349 CENTRAL STREET MANCHESTER, NH 03103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.03% |
| CHARLES NEWKERK3 | 74 N PALM WAY ROCKLEDGE, FL 32955 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| DEANNA BOUFFORD3 | 406 MAHOGANY RIDGE DR DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| JOHN E CUMMINGS3 Filed as: JOHN JOHNSON | 1618 FOX GLEN CT WINTER SPRINGS, FL 32708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| DEMOS GINAKES3 | 1020 W INTL SPWY BLVD DAYTONA BEACH, FL 32114 | 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 | $3K | $977 | $4K | 13.01% |
| WEB BENEFITS DESIGN CORPORATION5 | 4725 W SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $889 | $889 | 2.74% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | $733 | $3K | 12.87% |
| 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 | $474 | $2K | 12.71% |
| WEB BENEFITS DESIGN CORPORATION5 | 4725 W SAND LAKE RD, STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $482 | $482 | 2.75% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $187 | $131 | $318 | 15.64% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $182 | $51 | $233 | 11.46% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $11 | $44 | 2.16% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $9 | $24 | 1.18% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $3 | $18 | 0.89% |
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 | 277 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 278 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 512 | $3.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 226 | $193K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 135 | $26K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $112K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 69 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $98K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 512 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.