| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GROUP INC | 812 N VALRICO RD VALRICO, FL 33594 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $52K | $52K | 5.26% |
| BRENTLEY M HUXTABLE3 | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $11K | $365 | $12K | 15.05% |
| THE PERRY GROUP INC3 | 1650 SAND LAKE RD STE 201D ORLANDO, FL 32809 | AFLAC | $962 | $85 | $1K | 1.34% |
| DAVIDSON WALLACE3 | 707 SUNBURST COVE LN WINTER GARDEN, FL 34787 | AFLAC | $909 | $85 | $994 | 1.27% |
| NOLAN KING3 | 15690 W COLONIAL DR WINTER GARDEN, FL 34787 | AFLAC | $698 | — | $698 | 0.89% |
| KENNETH ERIK MANN3 | 9245 CUT SHOT DR WINTER GARDEN, FL 34787 | AFLAC | $208 | — | $208 | 0.27% |
| AMBER E SCHMALE PEREYRA3 | 555 S RANGER BLVD WINTER PARK, FL 32792 | AFLAC | $202 | — | $202 | 0.26% |
| LISA H PERRY3 | 1650 SAND LAKE RD STE 201D ORLANDO, FL 32809 | AFLAC | $122 | — | $122 | 0.16% |
| OMER S BASS IV3 | 565 W GATEWAY CT MERRITT ISLAND, FL 32952 | AFLAC | $45 | — | $45 | 0.06% |
| MKF & ASSOCIATES INC3 | 4222 MARDEN WAY VESTAVIA, FL 35242 | AFLAC | $15 | — | $15 | 0.02% |
| PATRICIA ANNE REILLY3 | 269 E LONG CREEK CV LONGWOOD, FL 32750 | AFLAC | $4 | — | $4 | 0.01% |
| DAWN T SUCHECKI3 | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $2 | — | $2 | 0.00% |
| DOUGLAS J SUCHECKI3 | 21 HEARTWOOD DR CATAULA, GA 31804 | AFLAC | $2 | — | $2 | 0.00% |
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GROUP INC | 4830 W KENNEDY BLVD STE 550 TAMPA, FL 33609 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.23% |
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GRP INC | 4830 WEST KENNEDY BLVD UNIT 550 TAMPA, FL 33609 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 12.00% |
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GRP INC | 4830 WEST KENNEDY BLVD TAMPA, FL 33609 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $870 | — | $870 | 5.66% |
| YOLANDA TRISTANCHO-HELWIG3 | 315 WEST 39TH STREET NEW YORK, NY 10018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $174 | — | $174 | 1.13% |
| COLIN JAMES MCDOUGALL3 | 4741 SOMERSET HILL LN RIVERVIEW, FL 33578 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 1.13% |
| GREGORY PAUL STAUDINGER3 | 5686 BROADVIEW RD APT 2132 CLEVELAND, OH 44134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $84 | $68 | $152 | 0.99% |
| ROBERT BRIAN FABRIZIO JR3 | 814 N VALRICO RD VALRICO, FL 33594 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 0.96% |
| TRILOGY BENEFITS CONSULTING LLC3 | 11635 GROVE ST SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $6 | $109 | 0.71% |
| DANIELS SOLUTIONS LLC3 | 13650 W HILLSBOROUGH AVE GREATER TAMPA, FL 33635 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $47 | $93 | 0.61% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $9 | $30 | 0.20% |
| STEVEN VERMETTE INC3 | 731 CYPRESS POINTE LANE HAYESVILLE, NC 28904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.10% |
| RONALD SADOFSKY3 | 14887 SEA MYRTLE LN HUDSON, FL 34667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.08% |
| CHOICE BENEFIT SOLUTIONS INC3 | 525 CAPRI BLVD TREASURE ISLAND, FL 33706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| ANDERSON BENEFIT SOLUTIONS3 | 3821 LAKE PADGETT DR LAND O LAKES, FL 34639 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| EXCALIBUR FINANCIAL GROUP3 Filed as: EXCALIBUR FINANCIAL GROUP INC | 4830 W KENNEDY BLVD STE 550, TAMPA, TAMPA, FL 33609 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 14.76% |
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 | 245 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 117 | $983K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 245 | $67K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 150 | $12K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 199 | $33K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 53 | $94K |
| Other | HARTFORD LIFE AND ACCIDENT | 199 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.