| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.13% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $20K | $9K | $29K | 11.53% |
| INSURANCE OFFICE OF AMERICA3 | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $2K | $12K | 36.99% |
| WORKSITE BENEFITS SOLUTION LLC3 | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 15.59% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON BUCZKOWSKI | 204 COVERED BRIDGE DRIVE OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $3K | 10.93% |
| MJ INSURANCE3 Filed as: KENNETH HOLDER AND VARIOUS AGENTS | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $734 | $3K | 10.49% |
| OMAR ENRIQUE FIGUEROA3 Filed as: OMAR FIGUEROA | 3424 DOUGLAS COURT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $550 | $3K | 8.83% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $940 | $2K | 7.25% |
| MICHAEL G BOYCE3 Filed as: MICHAEL BOYCE | 518 TENNESSEE AVENUE SAINT CLOUD, FL 34769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $827 | $841 | $2K | 5.32% |
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 | 292 | 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) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 240 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 292 | $248K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 292 | $248K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 292 | $279K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 292 | $248K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 240 | $2.0M |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 42 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.