| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITED HEALTTHCARE | $9K | $3K | $11K | 0.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6967 S RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | RELIANCE STANDARD | $6K | $3K | $9K | 17.67% |
| LASSITER WARE3 Filed as: LASSITER-WARE INS INC | 1317 CITIZENS BLVD LEESBURG, FL 34748 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $432 | $4K | 10.96% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE AMERICA LLC | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $551 | $2K | 5.73% |
| BRENDA GEISLER-MURPHY3 | 2939 PINEWOOD RUN PALM HARBOR, FL 34684 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.67% |
| SHIRLEY B DRAKE3 | 14141 46TH STREET N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $171 | $1K | 3.47% |
| PATRICIA M CARDUCCI3 Filed as: PATRICIA M COLLINS | 1708 CYPRESS TRACE DRIVE SAFETY HARBOR, FL 34695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $448 | $0 | $448 | 1.31% |
| SHELBY GROUP INC3 | 2550 STAG RUN BLVD CLEARWATER, FL 33765 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $245 | $0 | $245 | 0.72% |
| SUSANNE PAPA3 | 4750 STONEVIEW CIRCLE OLD SMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $106 | $0 | $106 | 0.31% |
| CORCORAN & HOYT LLC3 Filed as: CORCORAN & HOYT, LLC | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $0 | $47 | 0.14% |
| HEATHER PLANKEY3 | 8390 139TH LANE SEMINOLE, FL 33776 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.12% |
| CHRISTINA L SUTTON3 | PO BOX 746 OZONA, FL 34660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.06% |
| SARA ANN MATERA3 | 82 EASTWINDS COURT PALM HARBOR, FL 34683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | RELIANCE STANDARD | $2K | $943 | $3K | 17.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 6967 S RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $45 | $23 | $68 | 17.26% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTTHCARE | 275 | $1.6M |
| Dental | UNITED HEALTTHCARE | 275 | $1.6M |
| Vision | UNITED HEALTTHCARE | 275 | $1.6M |
| Life insurance | RELIANCE STANDARD | 311 | $16K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 134 | $52K |
| Long-term disability | RELIANCE STANDARD | 157 | $53K |
| Prescription drug | UNITED HEALTTHCARE | 275 | $1.6M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD | 311 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.