| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA | 1855 W STATE RD 434 SUITE 250 LONGWOOD, FL 32750 | BLUE CROSS BLUE SHIELD OF FLORIDA | $118K | — | $118K | 5.00% |
| INSURANCE OFFICE OF AMERICA | 1855 W STATE RD 434 SUITE 250 LONGWOORD, FL 32750 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $61K | $13K | $74K | 13.44% |
| INSURANCE OFFICE OF AMERICA | 1855 W STATE RD 434 SUITE 250 LONGWOOD, FL 32750 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21K | $4K | $25K | 17.77% |
| WORKSITE BENEFITS SOLUTION LLC Filed as: WORKSITE BENEFITS SOLUTIONS INC | 323 PLEASANT ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 5.52% |
| SARAH WEYMOUTH | 306 MAPLE AVE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $5K | 3.48% |
| OMAR ENRIQUE FIGUEROA | 3424 DOUGLAS CT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $322 | $4K | 2.87% |
| CALVON Y BUCZKOWSKI Filed as: CALVON BUCZKOWSKI | 2608 TALL MAPLE LOOP OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $791 | $2K | 1.70% |
| CARUSO INSURANCE BENEFITS INC | 10872 WILDERNESS CT ORLANDO, FL 32821 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $205 | $2K | 1.70% |
| KENNETH A HOLDER Filed as: KENNETH HOLDER | 870 GREENSHANK DR HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $134 | $2K | 1.69% |
| JENNIFER WEYMOUTH RESMONDO | 2940 OAKTREE DR KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $80 | $1K | 0.98% |
| ROBERT SHAVERS | 1537 COLONY AVE KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $949 | $64 | $1K | 0.71% |
| DEANNA BOUFFORD | 323 PLEASANT ST KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $857 | $10 | $867 | 0.61% |
| WINFREDA HELEN LUTZ | 16658 HAMILTON DR ORLANDO, FL 32833 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $738 | $0 | $738 | 0.52% |
| SHARI DIANNE FIELD | 262 OYHUT BAY BLVD SW OCEAN SHORES, WA 98569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $679 | $42 | $721 | 0.51% |
| MARYLINE Z ORELLANA Filed as: MARYLINE ORELLANA | 2949 CLIPPER COVE LANE KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $331 | $63 | $394 | 0.28% |
| ASHTON BROCK | 1708 LAUREL ST MOBILE, AL 36604 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $305 | $11 | $316 | 0.22% |
| JUDY INEZ BUCHOLTZ Filed as: JUDY BUCHOLTZ | 12517 217TH AVE CT E BONNEY LAKE, WA 98391 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $277 | $29 | $306 | 0.22% |
| SANDARA SIMS | 13750 W COLONIAL DR SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $192 | $79 | $271 | 0.19% |
| SABRINA S RAMOS Filed as: SABRINA RAMOS | 13750 W COLONIAL DR WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $151 | $79 | $230 | 0.16% |
| MARK CHARLES MORGAN | 2590 WILLIAMETTE DR LACEY, WA 98516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $179 | $230 | 0.16% |
| RENEE SESSIONS WILLIAMS | 1310 HIGHLAND CIR KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | $0 | $156 | 0.11% |
| ROXANA BUSCHMAN | 400 NORTHEAST 149TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | $9 | $130 | 0.09% |
| GLENN REEVES | PO BOX 797 FAIRHOPE, AL 36533 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $0 | $127 | 0.09% |
| CHRISTINE LYNN MORGESTER | 2137 N Q ST WASHOUGAL, WA 98671 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $19 | $119 | 0.08% |
| KERRY ANN TATE | 9949 BOCA CIR NAPLES, FL 34109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $6 | $108 | 0.08% |
| LEWIS ASHTON BROCK III Filed as: LEWIS A BROCK III | 8776 SPRING GROVE NORTH MOBILE, AL 36695 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $36 | $102 | 0.07% |
| D'ARCIPRETE & ASSOCIATES INC | 12945 US HWY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $47 | $69 | 0.05% |
| PAULA LEE BELLEY Filed as: PAULA BELLEY | 4317 LONGSHORE DR LAND O LAKES, FL 34639 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | $0 | $67 | 0.05% |
| JODI MOYLAN | 3658 BRIDGEPORT WAY W APT B302 UNIVERSITY PLACE, WA 98466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $6 | $57 | 0.04% |
| BRIAN WHITE Filed as: BRIAN RODERICK | 3104 MCALLISTER ST DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $25 | $52 | 0.04% |
| DEREK THURSTON | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $3 | $48 | 0.03% |
| NICHOLAS HALSTON GIROD | 8520 VALENCIA VILLAGE LANE ORLANDO, FL 32825 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.03% |
| PREMIER WORKSITE SOLUTIONS INC | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $11 | $30 | 0.02% |
| HR BENEFITS SERVICES, INC. Filed as: NW BENEFITS GROUP LLC | 3104 MCALLISTER ST DUPONT, WA 98327 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $14 | $28 | 0.02% |
| COLLETTE G BOISVERT Filed as: COLLETTE BOISVERT | 349 CENTRAL ST MANCHESTER, NH 03103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.02% |
| KARINA IBANEZ | 8520 VALENCIA VILLAGE LANE #203 ORLANDO, FL 32825 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.02% |
| MUSTAPHA KHINIT | 943 BATTERY POINTE DR ORLANDO, FL 32828 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.02% |
| BENEFITS BY DESIGN INC | 2101 NE 279TH ST RIDGEFIELD, WA 98642 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $5 | $17 | 0.01% |
| REEVES, RANDY Filed as: THE REEVES AGENCY INC | PO BOX 797 FAIRHOPE, AL 36533 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.01% |
| MICHAEL A DUARTE Filed as: MICHAEL DUARTE | 515 DULL ST DICKSON, TN 37055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $3 | $10 | 0.01% |
| INSURANCE OFFICE OF AMERICA | 1855 W STATE RD 434 SUITE 250 LONGWOOD, FL 32750 | FIDELITY SECURITY LIFE INSURANCE COMPANY - EYEMED | $2K | — | $2K | 9.69% |
No Schedule C service providers reported on this filing.
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 | 561 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 326 | $2.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 561 | $551K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY - EYEMED | 418 | $21K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 561 | $693K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 561 | $551K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 561 | $551K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 561 | $693K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 561 | — |
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.