| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $5K | $5K | 1.76% |
| UMR, INC.3 Filed as: UMR INC. | 115 W WAUSAU AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 0.48% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | AMERITAS LIFE INSURANCE CORP | $2K | $99 | $2K | 5.90% |
| OMS INSURANCE GROUP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| OMS OF NORTHWEST FLORIDA INC3 Filed as: OMS OF NORTHWEST FLORIDA | PO BOX 1097 SANTA ROSA BEACH, FL 32459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $441 | $1 | $442 | 6.75% |
| JOEY MIGUES3 Filed as: JOEY GRUBBS BENEFITS LLC | 4527 ARGYLE LN TALLAHASSEE, FL 32309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.43% |
| SHAUNET LOUISE PROKUSKI3 | PO BOX 2 LAKELAND, FL 33802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.05% |
| PRATT & ASSOCIATES INC3 Filed as: PRATT & ASSOCIATES | 3423 ASHLING DR LAKELAND, FL 33803 | AFLAC | $137 | — | $137 | 3.84% |
| RICHARD E DRESSER3 Filed as: RICHARD W BLOUNT | 842 PICKNEY LN THE VILLAGES, FL 32162 | AFLAC | $51 | — | $51 | 1.43% |
| ROBERT L TRAPNELL JR3 | 15 N INDIAN RIVER DR APT 705 COCOA, FL 32922 | AFLAC | $28 | — | $28 | 0.78% |
| A VIC DAVIES3 | — | AFLAC | $19 | — | $19 | 0.53% |
| ALVIS B RIESENBERG3 | 2645 DAYTIME CT GULF BREEZE, FL 32583 | AFLAC | $19 | — | $19 | 0.53% |
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 | 129 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 110 | $41K |
| Vision | AMERITAS LIFE INSURANCE CORP | 110 | $41K |
| Life insurance(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $19K |
| Short-term disability(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 129 | $19K |
| Stop-loss / reinsurancereinsurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $543K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.