| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 3875 HOPYARD RD STE 240 PLEASANTON, CA 94588 | SUN LIFE ASSURANCE COMPANY OF CANADA | $69K | $13K | $82K | 13.04% |
| INSURANCE OFFICE OF AMERICA3 | 1855 W STATE ROAD 434 SUITE 250 LONGWOOD, FL 32750 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $55K | $15K | $70K | 13.19% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32K | $10K | $42K | 10.71% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | $8K | $22K | 5.57% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $4K | $14K | 3.53% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS CT. KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $2K | $10K | 2.70% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $3K | $8K | 2.02% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 1.66% |
| BARBARA C BRENLOVE3 | PO BOX 470701 CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.09% |
| DEANNA BOUFFORD3 | 323 PLEASANT ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 0.93% |
| KENNETH A HOLDER3 | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $143 | $3K | 0.87% |
| ROBERT SHAVERS3 | 1537 COLONY AVE KISSIMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.67% |
| CARUSO INSURANCE BENEFITS INC3 | 10872 WILDERNESS CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $132 | $2K | 0.59% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ3 | 2022 ESTANCIA CIR STE 6 KISSIMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $506 | $2K | 0.57% |
| COLLETTE G BOISVERT3 | 349 CENTRAL STREET MANCHESTER, NH 03103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.50% |
| MICHAEL G BOYCE3 | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $271 | $2K | 0.42% |
| FAITH CRYSTAL TAYLOR3 | 431 AUSTRALIAN WAY DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $395 | $2K | 0.40% |
| MARGIE LEE SHELDON3 | 325 EUNICE RD. LAKELAND, FL 33803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $991 | $537 | $2K | 0.39% |
| SAMANTHA C CORTELAZZO-ABBATE3 | 1283 TWIN RIVERS BLVD OVIEDO, FL 32766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.34% |
| DEBRA DAIGLE AMOEDO3 | 12750 GRECO DRIVE ORLANDO, FL 32824 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $815 | — | $815 | 0.21% |
| MUSTAPHA KHINIT3 | 943 BATTERY POINTE DRIVE ORLANDO, FL 32828 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $456 | — | $456 | 0.12% |
| EMPLOYEE BENEFITS GROUP OF FLORIDA3 | 855 S DILLARD ST WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $159 | $285 | 0.07% |
| CORCORAN & HOYT LLC3 | 12505 BRONCO DRIVE TAMPA, FL 33624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $126 | $57 | $183 | 0.05% |
| MARYLINE Z ORELLANA3 | 2949 CLIPPER COVE LANE KISSIMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | — | $179 | 0.05% |
| BIANCA NAVARRO3 | 4082 NORTH 10TH ST HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $4 | $69 | 0.02% |
| C LAMBERT INC3 | 3717 GRIFFIN AVE LADY LAKE, FL 32159 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.01% |
| LASSITER WARE3 Filed as: LASSITER-WARE INS INC | 1317 CITIZENS BLVD LEESBURG, FL 34748 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.01% |
| VILMA RIVERA3 | 11098 GRANDE PINES CIRCLE ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.01% |
| JAMIE A CONTRERAS-VESTAL3 | P.O. BOX 1240 DELAND, FL 32721 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.00% |
| GINAKES & ASSOCIATES LLC3 | 1020 W INTERNATIONAL SPEEDWAY DAYTONA BEACH, FL 32114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.00% |
| BRIAN R CHOWNING3 | 36241 S GRAYS AIRPORT RD FRUITLAND PARK, FL 34731 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.00% |
| ROBERT GONZALEZ SR3 | 10052 BRIGHTFIELD CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.00% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $4 | $6 | 0.00% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $971 | $4K | 10.39% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $787 | $2K | 5.16% |
| OMAR ENRIQUE FIGUEROA3 | 3424 DOUGLAS CT. KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $321 | $2K | 4.33% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $961 | $391 | $1K | 3.20% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $500 | $276 | $776 | 1.84% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $513 | $137 | $650 | 1.54% |
| BARBARA C BRENLOVE3 | PO BOX 470701 CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $421 | — | $421 | 1.00% |
| KENNETH A HOLDER3 | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $338 | $13 | $351 | 0.83% |
| SAMANTHA C CORTELAZZO-ABBATE3 | 1283 TWIN RIVERS BLVD OVIEDO, FL 32766 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $350 | — | $350 | 0.83% |
| DEBRA DAIGLE AMOEDO3 | 12750 GRECO DRIVE ORLANDO, FL 32824 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $264 | — | $264 | 0.62% |
| MARGIE LEE SHELDON3 | 325 EUNICE RD. LAKELAND, FL 33803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $67 | $191 | 0.45% |
| MICHAEL G BOYCE3 | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $32 | $189 | 0.45% |
| DEANNA BOUFFORD3 | 406 MAHOGANY RIDGE DR DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $133 | — | $133 | 0.31% |
| CARUSO INSURANCE BENEFITS INC3 | 10872 WILDERNESS CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $99 | $4 | $103 | 0.24% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ3 | 2022 ESTANCIA CIR STE 6 KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $10 | $43 | 0.10% |
| ROBERT SHAVERS3 | 1537 COLONY AVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | — | $36 | 0.09% |
| FAITH CRYSTAL TAYLOR3 | 431 AUSTRALIAN WAY DAVENPORT, FL 33897 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $6 | $23 | 0.05% |
| VILMA RIVERA3 | 11098 GRANDE PINES CIRCLE ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| EMPLOYEE BENEFITS GROUP OF FLORIDA3 | 13750 W COLONIAL DRIVE STE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.01% |
| CORCORAN & HOYT LLC3 | 12505 BRONCO DRIVE TAMPA, FL 33624 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE RD 434 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $4 | $34 | 4.30% |
| WORKSITE BENEFITS SOLUTION LLC3 | 1009 VERONA ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $3 | $20 | 2.53% |
| KENNETH A HOLDER3 | 870 GREENSHANK DRIVE HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $1 | $19 | 2.41% |
| CALVON Y BUCZKOWSKI3 | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $1 | $14 | 1.77% |
| SARAH WEYMOUTH3 | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $2 | $13 | 1.65% |
| JENNIFER WEYMOUTH RESMONDO3 | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.63% |
| BARBARA C BRENLOVE3 | PO BOX 470701 CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 84-0467907 OTHER FEES | Other fees Service code 99 | — | $162K |
| PREFERRED BENEFIT ADMINISTRATORS EIN 59-3476829 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $118K |
| INSURANCE OF AMERICA EIN 59-2476256 INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | — | $97K |
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 | 803 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 804 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 797 | $528K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 797 | $528K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 797 | $528K |
| Short-term disability(3 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 609 | $431K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 797 | $528K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 813 | $628K |
| Other(4 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 797 | $959K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 813 | — |
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.