| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED Filed as: HUB INTERNATIONAL MIDWEST LTD | 2811 NW 41ST ST STE A GAINESVILLE, FL 32606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | $4 | $167 | 4.67% |
| ELIZABETH MARIE LANGEVIN Filed as: ELIZABETH ANNE FELL | 775 PROVIDENCE ISLAND CT. JACKSONVILLE, FL 32225 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 3.33% |
| JAYME BAILY | 2975 SE 36TH STREET OCALA, FL 34471 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.84% |
| ALLISON JAMIE TAMARES | 9041 COUNTY MILL ROAD JACKSONVILLE, FL 32222 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.76% |
| JESSE DUANE DAVIS | 2164 UNITY TRAIL NW MARIETTA, GA 30064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.76% |
| CHARLES LEE HETHER | 12 COURTYARD CMN HILTON HEAD ISLAND, SC 29926 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $20 | $24 | 0.67% |
| JASON ANDREW BAILY | 2975 SE 36TH ST OCALA, FL 34471 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $17 | $19 | 0.53% |
| CAPTURED MOMENTS BY KATE LLC Filed as: CAPTURED MOMENTS BY KATE | 4892 CASTLEGATE CT JACKSONVILLE, FL 32256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.11% |
| ALYSON MARIE MCMAHON | 2127 GRASSY BASIN CT. JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.06% |
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 | 2 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 2 | $4K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 2 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.