| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 N PIMA RD STE 210 SCOTTSDALE, AZ 85255 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 0.95% |
| UMR, INC.3 Filed as: UMR INC | 11 SCOTT ST STE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 0.66% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $4K | $20K | 21.51% |
| BENETEK CORPORATION3 | 4275 WEST SAND LAKE RD ORLANDO, FL 32819 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 2.33% |
| HARRISON-DAVIS INC3 Filed as: HARRISON DAVIS | 5426 BAY CENTER DR STE 550 TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $29 | — | $29 | 0.03% |
| DAVIS II COMPANIES LLC3 | 5426 BAY CENTER DR TAMPA, FL 33609 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3 | — | $3 | 0.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| 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 | — | $3K | $3K | 8.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| 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 | — | $2K | $2K | 8.00% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| 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 | — | $2K | $2K | 8.00% |
| ENROLLMENT ALLIANCE LLC3 | 1724 E 5TH AVE TAMPA, FL 33605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $322 | — | $322 | 3.11% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | SUN LIFE ASSURANCE COMPANY OF CANADA | $138 | — | $138 | 1.33% |
| OMS INSURANCE GROUP3 | PO BOX 2 LAKELAND, FL 33802 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $833 | — | $833 | 10.00% |
| 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 | — | $667 | $667 | 8.00% |
| 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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $93K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $93K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $55K |
| Short-term disability(5 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $177K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 198 | $34K |
| Stop-loss / reinsurancereinsurance(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 116 | $677K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.