| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | BLUE CROSS BLUE SHIELD OF FLORIDA | $2K | $0 | $2K | 0.91% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | HEALTH OPTIONS | $1K | $0 | $1K | 0.95% |
| INSURANCE OFFICE OF AMERICA3 | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | BEHEALTHY FLORIDA | $1K | $0 | $1K | 1.14% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $2K | $13K | 14.71% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $68 | $4K | 8.43% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTIONS LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $474 | $2K | 3.85% |
| MJ INSURANCE3 Filed as: BIANCA NAVARRO AND VARIOUS AGENTS | 4082 NORTH 10TH STREET HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $253 | $2K | 3.37% |
| SARAH WEYMOUTH3 | 107 OCEAN TERRACE INDIATLANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $672 | $261 | $933 | 2.06% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS COURT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $474 | $108 | $582 | 1.28% |
| DEBRA DAIGLE AMOEDO3 | 12750 GRECO DRIVE ORLANDO, FL 32824 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $491 | $10 | $501 | 1.11% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON BUCZKOWSKI | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $282 | $193 | $475 | 1.05% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $478 | $0 | $478 | 8.79% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTIONS LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | $28 | $184 | 3.38% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON BUCZKOWSKI AND OTHER AGENTS | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | $14 | $145 | 2.67% |
| BIANCA NAVARRO3 | 8005 HEMINGWAY CIRCLE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $49 | $143 | 2.63% |
| SARAH WEYMOUTH3 | 107 OCEAN TERRACE INDIATLANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | $54 | $140 | 2.57% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS COURT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | $11 | $81 | 1.49% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER LEE WEYMOUTH | 2940 OAKTREE DRIVE KISSIMME, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $33 | $69 | 1.27% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 24 | $477K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $86K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $86K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $86K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $86K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 24 | $477K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.