| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS SELF FUNDED LLC | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $22K | $9K | $31K | 6.98% |
| UMR, INC.3 Filed as: UMR INC | 115 W WAUSAU AVE WASAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 0.54% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | GUARDIAN | $2K | $1K | $3K | 4.03% |
| BENETEK CORPORATION3 | 6277 SEA HARBOR DR STE 201 ORLANDO, FL 32821 | GUARDIAN | $3K | — | $3K | 4.00% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS INC | — | GUARDIAN | $12 | — | $12 | 0.01% |
| CTL SERVICES INC3 Filed as: CTL TAMPA LLC | — | GUARDIAN | $8 | — | $8 | 0.01% |
| DAVIS II COMPANIES LLC3 | — | GUARDIAN | $2 | — | $2 | 0.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $868 | $868 | 8.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $564 | $564 | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $352 | — | $352 | 4.99% |
| FOUNDATION RISK PARTNERS CORP3 | 4634 GULFSTARR DR DESTIN, FL 32541 | SUN LIFE ASSURANCE COMPANY OF CANADA | $818 | — | $818 | 20.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $76K |
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 | 119 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 85 | $83K |
| Vision | GUARDIAN | 85 | $83K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $26K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 33 | $7K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 119 | $447K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 11 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.