| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHN ADCOCK INSURANCE AGENCY INC3 | 313 W FLETCHER AVE TAMPA, FL 33612 | UNITEDHEALTHCARE INSURANCE COMPANY | $52K | — | $52K | 3.85% |
| LASSITER WARE3 Filed as: LASSITER-WARE LLC | 1317 CITIZENS BLVD LEESBURG, FL 34748 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | — | $16K | 1.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: LASSITERWARE, INC. | 1300 N. WESTSHORE BLVD. STE 110 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 12.51% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | C/O GROUP INSURANCE SERVICES INC 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $740 | — | $740 | 5.00% |
| LASSITER WARE3 Filed as: LASSITER-WARE INC | 1317 CITIZENS BLVD LEESBURG, FL 34748 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $368 | — | $368 | 2.49% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $263 | $263 | 1.78% |
| NFP INSURANCE SERVICES INC3 | 1250 CAPITAL OF TX HWY S BLDG II STE 600 AUSTIN, TX 78746 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $164 | $164 | 1.11% |
| JOHN ADCOCK INSURANCE AGENCY INC3 | 313 W FLETCHER AVE TAMPA, FL 33612 | HUMANA - COMPBENEFITS COMPANY | $1K | — | $1K | 8.30% |
| LASSITER WARE3 Filed as: LASSITER-WARE INC-LAKE COUNTY | PO BOX 490690 LEESBURG, FL 34749 | HUMANA - COMPBENEFITS COMPANY | $228 | — | $228 | 1.70% |
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 | 97 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 283 | $1.4M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 283 | $1.4M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 283 | $1.4M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 102 | $15K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 102 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.