| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $4K | $6K | 8.83% |
| BENETEK CORPORATION3 | 4275 WEST SAND LAKE RD ORLANDO, FL 32819 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.24% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS INC | 5426 BAY CENTER DR TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.03% |
| DAVIS II COMPANIES LLC3 | 5426 BAY CENTER DR TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9 | — | $9 | 0.01% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFIT DESIGNS | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $978 | $978 | 8.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $576 | $576 | 8.01% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | $855 | — | $855 | 12.89% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $419 | $419 | 8.01% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $262 | — | $262 | 5.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $121K |
| OMS INSURANCE GROUP EIN 59-3757026 BROKER | Other commissions Service code 55 | PO BOX 2 LAKELAND, FL 33802 | $50K |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 66 | $63K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 66 | $63K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $19K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 142 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 35 | $5K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $266K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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."
No prospect flags tripped on this filing.