| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LASSITER WARE3 Filed as: LASSITER WARE INC | 1317 CITIZENS BLVD LEESBURG, FL 347483923 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $1K | $20K | 9.91% |
| DONALD R JAWORSKI3 | 20819 ORCHARDTOWN DRIVE LAND O LAKES, FL 34638 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $166 | $4K | 5.11% |
| LASSITER WARE3 Filed as: LASSITER WARE INC | PO BOX 490690 LEESBURG, FL 34749 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $167 | $2K | 2.48% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS | 9500 KOGER BLVD ST PETERBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $105 | $2K | 1.80% |
| STEPHANIE SHEPPA3 | 3687 IMPERIAL RIDGE PKWY PALM HARBOR, FL 34684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $117 | $1K | 1.47% |
| TIMOTHY B DONNELLY3 | 5960 92ND AVE N PINELLAS PARK, FL 33782 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $571 | $21 | $592 | 0.70% |
| PATMAR GROUP INC3 | 13214 88TH PL N SEMINOLE, FL 33776 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $377 | $19 | $396 | 0.47% |
| PAT WILLIAMS INSURANCE CONSULTANTS3 | 18201 GULF BLVD REDINGTON SHORES, FL 33708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $316 | — | $316 | 0.38% |
| ADVANCED PLANNING CENTER INC3 | PO BOX 910 INVERNESS, FL 34451 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $223 | — | $223 | 0.27% |
| TABBITHA ROSE3 | 1018 CABLE LANE PALM BAY, FL 34684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 0.21% |
| BRYAN ANTHONY GONZALEZ3 | 8408 QUARTZ PL TAMPA, FL 33615 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $114 | $17 | $131 | 0.16% |
| CRISTY L MATHEWS3 | 7 AZALEA DRIVE COCOA BEACH, FL 32931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.10% |
| CTI SERVICES INC.3 Filed as: CTI SERVICES INC | 1140 CLIMBING ROSE DR ORLANDO, FL 32818 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $10 | $46 | 0.05% |
| TRILOGY BENEFITS CONSULTING LLC3 | 5908 HAMMOCK WOODS DRIVE ODESSA, FL 33556 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $6 | $12 | 0.01% |
| ANDERSON BENEFIT SOLUTIONS3 | 3821 LAKE PADGETT DR LAND O LAKES, FL 34639 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $6 | $12 | 0.01% |
| WAYNE CUNNINGHAM3 | 388 HIGH TIDE DRIVE ST. AUGUSTINE, FL 32080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.01% |
| JOHN E CUMMINGS3 Filed as: JOHN JOHNSON | 1618 FOX GLEN CT WINTER SPRINGS, FL 32708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| ROSA SHALA3 | 16112 HARBOUR VISTA CIR ST AUGUSTINE, FL 32080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| THOMAS WALLACE JR3 | PO BOX 3654 PONTE VEDRA, FL 32004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| CHRISTINA MARIE KONCZESKI3 | 648 S STREET APT2 BOSTON, MA 02131 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 233 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 401 | $204K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 401 | $204K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 401 | $204K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 401 | $204K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 233 | $1.4M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 401 | $204K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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.