| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, CA 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | $33K | $4K | $37K | 5.42% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, CA 32750 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 14.13% |
| INSURANCE OFFICE OF AMERICA3 | 3875 HOPYARD ROAD, SUITE 240 PLEASANTON, CA 94588 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $957 | $957 | 2.64% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, CA 32750 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $913 | $3K | 27.90% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA STREET KISSIMEE, FL 34741 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $615 | $546 | $1K | 10.33% |
| SARAH WEYMOUTH3 | 306 MAPLE AVENUE KISSIMEE, FL 34761 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $343 | $176 | $519 | 4.62% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $138 | $119 | $257 | 2.29% |
| COLLETTE G BOISVERT3 Filed as: COLLETTE G. BOISVERT | 349 CENTRAL STREET MANCHESTER, NH 03103 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $236 | $0 | $236 | 2.10% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $50 | $185 | 1.65% |
| MJ INSURANCE3 Filed as: DEANNA BOUFFORD AND VARIOUS AGENTS | 406 MAHOGANY RIDGE DRIVE DAVENPORT, FL 33897 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $1 | $36 | 0.32% |
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 | 187 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 183 | $683K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 183 | $683K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 183 | $683K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $36K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $36K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $36K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 183 | $683K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 187 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.