| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARNTER GROUP LLC | 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 5.01% |
| UMR, INC.3 Filed as: UMR INC | 115 W WASAU AVE WASAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $3K | $3K | 0.55% |
| FOUNDATION RISK PARTNERS CORP3 | PO BOX 2 LAKELAND, FL 33802 | GUARDIAN | $6K | $3K | $10K | 9.71% |
| BENETEK CORPORATION3 | 4275 WEST SAND LAKE RD ORLANDO, FL 32819 | GUARDIAN | $4K | — | $4K | 4.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.56% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.44% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.64% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.36% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 8.51% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.50% |
| ENROLLMENT ALLIANCE LLC3 | 1302 N 19TH ST SUITE 150 TAMPA, FL 33605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $984 | — | $984 | 12.81% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 4634 GULFSTARR DR DESTIN, FL 32541 | SUN LIFE ASSURANCE COMPANY OF CANADA | $422 | $220 | $642 | 8.36% |
| OMS INSURANCE GROUP5 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $555 | $555 | 7.99% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $399 | — | $399 | 5.75% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $295 | — | $295 | 4.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $114K |
| OMS INSURANCE GROUP INC EIN 59-3757026 BROKER | Other commissions Service code 55 | PO BOX 2 LAKELAND, FL 33802 | $71K |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 133 | $98K |
| Vision | GUARDIAN | 133 | $98K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $24K |
| Short-term disability(3 contracts, 2 carriers) | GUARDIAN | 210 | $130K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $22K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 160 | $512K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 13 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.