| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $120K | $120K | 3.74% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | UNITEDHEALTHCARE INSURANCE COMPANY | $15K | $4K | $19K | 12.69% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $21 | $3K | 5.33% |
| MJ INSURANCE3 Filed as: JENNIFER WYMOUTH AND VARIOUS AGENTS | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $74 | $1K | 2.38% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFIT SOLUTION LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $951 | $120 | $1K | 1.95% |
| SARAH WEYMOUTH3 | 107 OCEAN TERRACE INDIATLANTIC, FL 32903 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $669 | $94 | $763 | 1.39% |
| KENNETH A HOLDER3 Filed as: KENNETH A. HOLDER | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $445 | $11 | $456 | 0.83% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS COURT KISSIMMEE, FL 34746 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $360 | $8 | $368 | 0.67% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $294 | $74 | $368 | 0.67% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 9.37% |
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 | 501 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 375 | $3.2M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 501 | $151K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 501 | $151K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 501 | $151K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 108 | $55K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 375 | $3.2M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 501 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.