| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROGER BOUCHARD INSURANCE INC3 Filed as: ROGER BOUCHARD INSURANCE | 101 STARCREST DR NORTH CLEARWATER, FL 33765 | AETNA LIFE INSURANCE CO | $6K | $503 | $7K | 12.56% |
| STEVEN VERMETTE INC3 | 920 SPRING PARK LOOP CELEBRATION, FL 34747 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $543 | $4K | 15.82% |
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $155 | $2K | 5.44% |
| SHIRLEY B DRAKE3 | 14141 46TH ST N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $782 | $266 | $1K | 3.72% |
| RICHARD LEWIS SOLLNER3 Filed as: RICHARD ANTHONY CALIFANO | 3007 W SAN ISIDRO ST TAMPA, FL 33629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $554 | $35 | $589 | 2.09% |
| HARRY M BARASH3 | 2510 SUMMERDALE CT CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $390 | $12 | $402 | 1.43% |
| SUSANNE PAPA3 | 4750 STONEVIEW CIRCLE OLD SMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $354 | — | $354 | 1.26% |
| MARK F BARRETT LLC3 | 14141 46TH ST N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $76 | $301 | 1.07% |
| TERRY B DRAKE3 | 14141 46TH AVE N CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.33% |
| EMMA ANN DEAN3 | 350 SOUTH BELVEDERE DR HAMPSTEAD, NC 28443 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.16% |
| THOMAS WALLACE JR3 | PO BOX 3654 PONTE VEDRA, FL 32004 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 0.14% |
| WALTER H MODARELLI3 | 11502 CARROLLWOOD DR TAMPA, FL 33618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.13% |
| ANN ASCANI3 | 2809 WINDING TRAIL DR VALRICO, FL 33596 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 103 | $53K |
| Dental | AETNA LIFE INSURANCE CO | 103 | $53K |
| Vision | AETNA LIFE INSURANCE CO | 103 | $53K |
| Life insurance | AETNA LIFE INSURANCE CO | 103 | $53K |
| Short-term disability | AETNA LIFE INSURANCE CO | 103 | $53K |
| Long-term disability | AETNA LIFE INSURANCE CO | 103 | $53K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 103 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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.