| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $29K | $11K | $40K | 6.75% |
| UMR, INC.3 Filed as: UMR INC | 115 W WAUSAU AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 0.57% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | GUARDIAN | $11K | $2K | $12K | 11.46% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 17.71% |
| WORKSITE AMERICA LLC3 Filed as: WORKSITE AMERICA | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $625 | $404 | $1K | 3.21% |
| CHOICE BENEFITS SOLUTIONS LLC3 | 11399 81ST PL SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $552 | $299 | $851 | 2.66% |
| LISA HEIL BUSENBARK3 | 3909 SHORESIDE CIRCLE TAMPA, FL 33624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | $5 | $69 | 0.22% |
| HEIL BUSINESS SOLUTIONS CORPORATION3 | 3909 SHORESIDE CIRCLE TAMPA, FL 33624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.12% |
| RONALD WIMBERLEY3 | PO BOX 1097 SANTA ROSA BEACH, FL 32459 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.11% |
| JAQUELYN LORETTA CARTER3 Filed as: JAQUELYN CARTER | 4416 LARKFIELD LN TAMPA, FL 33624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| PJ SKELTON LLC3 | 8163 REDONDA LOOP LAKEWOOD RANCH, FL 34202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| GRUBBS INSURANCE3 | 525 TAYLOR RD MONTICELLO, FL 32344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| NICOLE VEDDER3 | 6548 WILDEMEADEPL TALLAHASSEE, FL 32309 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ3 Filed as: ANGEL VELAZQUEZ DIAZ | 2022 ESTANCIA CIR STE 6 KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOHN ANTHONY CARREIRO III3 Filed as: JOHN ANTHONY CARREIRO | 11750 CAPRI CIR S APT 3 TREASURE ISLAND, FL 33706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| THOMAS WALLACE JR3 | 200 COUNTY RD 444 OXFORD, MS 38655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JOEY GRUBBS BENEFITS LLC3 Filed as: JOEY GRUBBS BENEFITS | 525 TAYLOR RD MONTICELLO, FL 32344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $89K |
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 | 304 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 197 | $106K |
| Vision | GUARDIAN | 197 | $106K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 304 | $97K |
| Short-term disability(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 304 | $158K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 85 | $59K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 168 | $588K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 304 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.