| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONS INSURANCE INC3 Filed as: REGIONS INSURANCE, INC | 6000 POPLAR AVENUE SUITE 300 MEMPHIS, TN 381190928 | HUMANA INSURANCE COMPANY | $5K | $180 | $5K | 10.37% |
| JAN HAMBY ALDAMUY3 | 16203 MUIRFIELD DRIVE ODESSA, FL 33556 | AFLAC | $2K | $848 | $3K | 17.69% |
| HUMBERT ALDAMUY JR3 Filed as: HUMBERT ALDAMUY, JR | 16203 MUIRFIELD DRIVE ODESSA, FL 33556 | AFLAC | $2K | $741 | $2K | 15.66% |
| LEE STEWART HOFFMAN3 | 20214 HERITAGE POINT DR TAMPA, FL 33647 | AFLAC | $836 | $494 | $1K | 8.82% |
| KATHRYN SUZANNE AXENTE3 | 500 N WEST SHORE BLVD STE 1015 TAMPA, FL 33609 | AFLAC | $528 | $344 | $872 | 5.78% |
| BARBARA SUSAN HOFFMAN3 | 20214 HERITAGE POINT DR TAMPA, FL 33647 | AFLAC | $162 | $179 | $341 | 2.26% |
| LUPIE TONIE GUERRERO3 | 804 KINGS ROW COHUTTA, GA 30710 | AFLAC | $116 | $102 | $218 | 1.45% |
| DEREK W STRANGE3 | PO BOX 200275 CARTERSVILLE, GA 30120 | AFLAC | $31 | $20 | $51 | 0.34% |
| REBECCA WILLMORE3 | 17449 QUEENSLAND STREET LAND O LAKES, FL 34638 | AFLAC | $50 | — | $50 | 0.33% |
| JUDY M BIRD3 | 1905 RICHLAND LN DALTON, GA 30720 | AFLAC | $19 | $20 | $39 | 0.26% |
| ISABEL GARCIA FARNHAM3 | 12144 ROCK DUCK AVE WEEKI WACHEE, FL 34614 | AFLAC | $36 | — | $36 | 0.24% |
| LINDA MCCOY3 | 509 PINE STREET PALMETTO, GA 30268 | AFLAC | $23 | — | $23 | 0.15% |
| JOHN MICHAEL GRUBBS3 | 34931 US HWY 19N PALM HARBOR, FL 34684 | AFLAC | $11 | — | $11 | 0.07% |
| JOSEPH BAILEY DUCKETT3 | 517 PINEWOOD DR OLDSMAR, FL 34677 | AFLAC | $7 | — | $7 | 0.05% |
| DONNA N THOMAS3 | 71 MONTROSE LN SHARPSBURG, GA 30277 | AFLAC | $5 | — | $5 | 0.03% |
| ANDY B GLENN II3 | 100 HARTSFIELD CENTER PKWY STE 500 ATLANTA, GA 30354 | AFLAC | $3 | — | $3 | 0.02% |
| BARTLEIN AND ASSOC INC3 | 5577 BROADCAST COURT SARASOTA, FL 34240 | AFLAC | $3 | — | $3 | 0.02% |
| SUSAN C BRIMHALL3 | 3921 CAPE SAN BLAS RD PORT SAINT JOE, FL 32456 | AFLAC | $1 | — | $1 | 0.01% |
| REGIONS INSURANCE INC3 Filed as: REGIONS INS INC | 6000 POPLAR AVENUE STE 300 MEMPHIS, TN 381190928 | HUMANA MEDICAL PLAN, INC. | $5K | — | $5K | — |
| REGIONS INSURANCE INC3 Filed as: REGIONS INS INC | 6000 POPLAR AVENUE STE 300 MEMPHIS, TN 381190928 | HUMANA INSURANCE COMPANY | -$34 | — | -$34 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REBSAMEN INSURANCE INC BROKER | Insurance agents and brokers Service code 22 | REGIONS INSURANCE DEPT 268 PO BOX 11407 BIRMINGHAM, AL 35246 | $37K |
| REGIONS INS INC DBA REGIONS LIFE BR BROKER | Insurance agents and brokers Service code 22 | 200 CENTRAL AVENUE SUITE 630 ST. PETERSBURG, FL 33701 | $0 |
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 | 185 | 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) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA MEDICAL PLAN, INC. | 0 | $0 |
| Dental | HUMANA INSURANCE COMPANY | 145 | $47K |
| Vision | HUMANA INSURANCE COMPANY | 145 | $47K |
| Life insurance | AFLAC | 171 | $15K |
| Short-term disability | AFLAC | 171 | $15K |
| Long-term disability | AFLAC | 171 | $15K |
| Other | AFLAC | 171 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.