| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38K | $2K | $41K | 13.60% |
| CHARLES D. BLOCK3 | 648 VILLAGE PARK DRIVE, UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $136 | $2K | 0.56% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $2 | $2K | 0.52% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | PO BOX 162207 ALTAMONTE SPRINGS, FL 32716 | DOMINION NATIONAL | $19K | $0 | $19K | 6.99% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | ADVANTICA REINSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
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 | 503 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DOMINION NATIONAL | 406 | $273K |
| Vision | ADVANTICA REINSURANCE COMPANY | 343 | $20K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 503 | $301K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 503 | $301K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 503 | $301K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 503 | — |
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.