| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DARRELL STANLEY BRANDIMORE3 | 3701 18TH AVENUE NORTH ST. PETERSBURG, FL 33713 | AFLAC | $4K | $41 | $4K | 5.32% |
| MA SERENITY LLC3 | 101 S. OLD COACHMAN RD APT 424 CLEARWATER, FL 33765 | AFLAC | $3K | $108 | $3K | 4.54% |
| LANCE SHNIDER3 | 401 E OGLETHORPE AVE APT 1114 SAVANNAH, GA 31401 | AFLAC | $995 | — | $995 | 1.34% |
| JAMES MCGRATH3 Filed as: JAMES PITTNER | 2749 BURNING TREE LANE CLEARWATER, FL 33761 | AFLAC | $863 | $41 | $904 | 1.22% |
| KRYSTINA EBERHART3 | 9170 RIDGEFIELD DRIVE BRIGHTON, MI 48114 | AFLAC | $312 | — | $312 | 0.42% |
| CARLA LOOPER3 Filed as: CARLA L. LOOPER | 704 PONCE DE LEON BLVD. BROOKSVILLE, FL 34601 | AFLAC | $286 | — | $286 | 0.39% |
| SHANE DAVISON3 Filed as: SHANE CRAIG DAVIDSON | 3013 LARGE HOP LANE ANTIOCH, TN 37013 | AFLAC | $184 | — | $184 | 0.25% |
| ASHLEY GADSON3 | 435 FULTON ST NE APT 1 LARGO, FL 33771 | AFLAC | $93 | $67 | $160 | 0.22% |
| RAVONE MARVELLE GRAHAM3 | 7601 ARCADIA TRAIL FORT WORTH, TX 76137 | AFLAC | $129 | — | $129 | 0.17% |
| SUSAN C BRIMHALL3 Filed as: SUSAN C. BRIMHALL | P.O. BOX 8 LAKE PLACID, NY 12946 | AFLAC | $123 | — | $123 | 0.17% |
| BETH LUANNE KIMBROUGH3 | 6750 N ANDREWS AVE STE 200 FORT LAUDERDALE, FL 33309 | AFLAC | $121 | — | $121 | 0.16% |
| KATHRYN SUZANNE AXENTE3 | 7020 PELICAN ISLAND DRIVE TAMPA, FL 33634 | AFLAC | $111 | — | $111 | 0.15% |
| BRANDY ANN HARTIN3 | 12203 STATE STREET TAMPA, FL 33635 | AFLAC | $96 | — | $96 | 0.13% |
| BRYON L GROVE3 Filed as: BRYON L. GROVE | 494 ORANGE STREET PALM HARBOR, FL 34683 | AFLAC | $61 | — | $61 | 0.08% |
| CHRISTOPHER W GRAHAM3 Filed as: CHRISTOPHER W. GRAHAM | 2 CHASE CORPORATE DR STE 460 HOOVER, AL 35244 | AFLAC | $57 | — | $57 | 0.08% |
| DAGMAR BENEDIK | — | AFLAC | $32 | — | $32 | 0.04% |
| JANINE FOX3 | 18 HAVILAND DRIVE SCHENECTADY, NY 12302 | AFLAC | $21 | — | $21 | 0.03% |
| FRANCIS V CRUZ3 | P.O. BOX 302 BRADFORD WOODS, PA 15015 | AFLAC | $9 | — | $9 | 0.01% |
| MICHELLE JAMES- YARISH3 | 501 PINEWOOD DRIV OLDSMAR, FL 34677 | AFLAC | $8 | — | $8 | 0.01% |
| MARY REBECCA WEATHERLY3 | 273 WILLIAMSBURG DRIVE MT WASHINGTON, KY 40047 | AFLAC | $6 | — | $6 | 0.01% |
| HORACE R WEAVER III3 Filed as: HORACE R. WEAVER III | 2512 GARDEN STREET MERAUX, LA 70075 | AFLAC | $4 | — | $4 | 0.01% |
| HELEN MARIE GENITO3 | 601 40TH ST N. APT 102 ST PETERSBURG, FL 33713 | AFLAC | $2 | — | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62689 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $54 | $1K | 1.68% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | P.O. BOX 62689 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $246 | $4K | 16.05% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62689 VIRGINIA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $108 | $2K | 15.95% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 90 | $74K |
| Dental | AFLAC | 90 | $74K |
| Life insurance(3 contracts, 2 carriers) | AFLAC | 144 | $109K |
| Short-term disability | AFLAC | 90 | $74K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 11 | $64K |
| Other(3 contracts, 2 carriers) | AFLAC | 144 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.