| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORKSITE AMERICA LLC3 Filed as: WORKSITE AMERICA | 14141 46TH STREET N, SUITE 1209 CLEARWATER, FL 33762 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 11.62% |
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS STREET, SUITE 100 TAMPA, FL 33607 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.23% |
| INSURANCE OFFICE OF AMERICA ONTARIO3 Filed as: INSURANCE OFFCIE OF AMERICA INC | 1855 WEST STATE ROAD 434 LONGWOOD, FL 32750 | HUMANA INSURANCE COMPANY | $3K | $2K | $5K | 14.05% |
| WORKSITE AMERICA LLC3 Filed as: WORKSITE AMERICA | 14141 46TH STREET N, SUITE 1209 CLEARWATER, FL 33762 | UNUM INSURANCE COMPANY | $1K | $0 | $1K | 10.10% |
| INSURANCE OFFICE OF AMERICA3 | 4915 W CYPRESS STREET, SUITE 100 TAMPA, FL 33607 | UNUM INSURANCE COMPANY | $552 | $3 | $555 | 5.14% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 63 | $37K |
| Vision | HUMANA INSURANCE COMPANY | 63 | $37K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $39K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $39K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $39K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 109 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.