| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 26 LAKE WIRE DR LAKELAND, FL 33815 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $4K | $9K | 11.10% |
| BENETEK CORPORATION3 | 4725 WEST SAND LAKE RD ORLANDO, FL 32819 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.00% |
| DAVIS II COMPANIES LLC3 | 5426 BAY CENTER DR STE 550 TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $74 | — | $74 | 0.09% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $169 | $3K | 15.84% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.75% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $252 | $252 | 1.26% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $244 | $3K | 16.41% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.54% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $252 | $252 | 1.46% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $163 | $3K | 16.02% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.67% |
| WEB BENEFITS DESIGN CORPORATION5 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $213 | $213 | 1.32% |
| ENROLLMENT ALLIANCE LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 14.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | $399 | — | $399 | 5.25% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 4634 GULFSTARR DR DESTIN, FL 32541 | SUN LIFE ASSURANCE COMPANY OF CANADA | $57 | — | $57 | 0.75% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $595 | $446 | $1K | 17.50% |
| WEB BENEFITS DESIGN CORPORATION3 Filed as: WEB BENEFITS DESIGN | 4725 W SAND LAKE RD STE 300 ORLANDO, FL 32819 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $79 | $79 | 1.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $135K |
| OMS INSURANCE GROUP EIN 59-3757026 BROKER | Other commissions Service code 55 | PO BOX 2 LAKELAND, FL 33802 | $63K |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $81K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 108 | $81K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $22K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $17K |
| Stop-loss / reinsurancereinsurance | STEALTH PARTNER GROUP | 108 | $362K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 13 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.