| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS3 Filed as: AMWINS SELF FUNDED LLC | 18700 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $33K | $14K | $46K | 7.07% |
| UMR, INC.3 Filed as: UMR INC | 115 W WAUSAU AVE WAUSAU, WI 54401 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.55% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 16.00% |
| BENETEK CORPORATION3 | 6277 SEA HARBOR DR STE 201 ORLANDO, FL 32821 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.66% |
| CTL SERVICES INC3 Filed as: CTL TAMPA LLC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $34 | — | $34 | 0.05% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS INC | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.02% |
| DAVIS II COMPANIES LLC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 0.02% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 8.00% |
| FOUNDATION RISK PARTNERS CORP3 | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 8.00% |
| EA LEGACY LLC3 | 1302 N 19TH ST STE 150 TAMPA, FL 33605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 10.40% |
| RISK STRATEGIES COMPANY3 Filed as: FOUDNATION RISK PARTNERS CORP | 4634 GULFSTARR DR DESTIN, FL 32541 | SUN LIFE ASSURANCE COMPANY OF CANADA | $807 | — | $807 | 4.46% |
| FOUNDATION RISK PARTNERS CORP3 Filed as: FOUNDATION RISK PARTNERS | 26 LAKE WIRE DR LAKELAND, FL 33815 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $716 | — | $716 | 10.00% |
| OMS INSURANCE GROUP5 Filed as: OMS INS GROUP LLC | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $573 | $573 | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $76K |
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 | 78 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 78 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 92 | $70K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 92 | $70K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $37K |
| Short-term disability(4 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 145 | $142K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $37K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 78 | $656K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 32 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.