| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID ADAMS3 Filed as: DAVID BLAIR ADAMS | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | KAISER FOUNDATION HEALTH PLAN, INC. | $23K | $0 | $23K | 4.43% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | KAISER FOUNDATION HEALTH PLAN, INC. | $2K | $0 | $2K | 0.42% |
| ADAMS BENEFIT CORPORATION3 Filed as: ADAMS BENEFIT CORP | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $502 | $13K | 7.17% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $48 | $9K | 5.30% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP, LLC | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.65% |
| CAROLE J CASELLA3 | 106 WATERVIEW DR PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 7.01% |
| ADAMS BENEFIT CORPORATION3 | 600 CORPORATE DR FORT LAUDERDALE, FL 33334 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.30% |
| LYNN MARIE BARRY3 | 301 W PARK AVE LANGHORNE, PA 19047 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $379 | $1K | 1.76% |
| CREATIVE BENEFIT CONSULTANTS INC3 | 18214 102ND WAY S STE 100 BOCA RATON, FL 33498 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $820 | $306 | $1K | 1.33% |
| JOSEPH A STALTARE3 | 11085 SACCO DR BOCA RATON, FL 33428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $341 | $222 | $563 | 0.67% |
| LISA M RUSSEY3 | 13080 NW 52ND ST CORAL SPRINGS, FL 33076 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $0 | $152 | 0.18% |
| PEACOCK FINANCIALS INC3 | 11830 NW 32ND MNR SUNRISE, FL 33323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $0 | $152 | 0.18% |
| YESENIA HENOHE OSORIO3 Filed as: YESENIA HENOCHE OSORIO | 13611 ISHNALA CIR WELLINGTON, FL 33414 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $148 | $0 | $148 | 0.17% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE PORTLAND, OR 97223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $147 | $0 | $147 | 0.17% |
| ANA ELISA FURNISS3 | 9022 SW 123RD CT APT 0-402 MIAMI, FL 33186 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $129 | $0 | $129 | 0.15% |
| GUSTAVO LIMA FELIPE3 | 11548 BIG SKY CT BOCA RATON, FL 33498 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.07% |
| CHRISTINA BIEBER3 | 12827 WOODMILL DR PALM BEACH GARDENS, FL 33418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.06% |
| LIZBETH RAMON3 | 16128 APPENNINE DR BROOKSVILLE, FL 34601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $0 | $46 | 0.05% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ3 Filed as: ANGEL GABRIEL VALAZQUEZ-DIAZ | 2022 ESTANCIA CIR STE 6 KISSIMMEE, FL 34741 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 0.05% |
| EMANUEL JULIAN ASURZA3 | 10445 ATLANTIC AVE RICHMOND HILL, NY 11418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $31 | $0 | $31 | 0.04% |
| LILIANA C BOSCH3 | 22861 SW 114TH PATH MIAMI, FL 33170 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.03% |
| SUMMIT FINANCIAL GROUP INC.3 Filed as: SUMMIT BENEFIT SOLUTIONS INC | 12223 HIGHLAND AVE 106 RANCHO CUCAMONGA, CA 91739 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.03% |
| MS HEALTH ECONOMICS CONSULTANTS LLC3 Filed as: MS HEALTH ECONOMICS CONSULTANTS LL | 10459 SW 78TH ST MIAMI, FL 33173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $0 | $24 | 0.03% |
| MARIA D KADALA3 Filed as: MARIA DOLORES KADALA | 1830 N UNIVERSITY DR PLANTATION, FL 33322 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.02% |
| LUCAS GARTENMAYER3 | 39051 12TH AVE ZEPHYRHILLS, FL 33542 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.02% |
| JEFFREY ADRIAN BORG3 | 3665 SAWGRASS DR TITUSVILLE, FL 32780 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.01% |
| ROSE VILLALON PASQUEL3 | 552 E CARSON ST STE 104-412 CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.01% |
| HEARTEASE LLC3 | 1521 NE 63RD AVE HILLSBORO, OR 97124 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $5 | $10 | 0.01% |
| MARIELENA HERRERA3 | 12338 DORA TRL PARRISH, FL 34219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.01% |
| JUAN PABLO CONTESSE3 | 1210 SW 106TH ST MIAMI, FL 33186 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| ALDEN D MCGEE3 | 3657 RICHMOND ST JACKSON, FL 32205 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| GREGORIO R UGAZ3 | 12300 SW 36TH ST MIAMI, FL 33175 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| WORKSITE BENEFITS GROUP INC3 | 112 NW 114TH ST VANCOUVER, WA 98685 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| GUY SANMIGUEL3 | 4965 SW 134TH AVE MIRAMAR, FL 33027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| WILLIAM E GECEWICZ3 Filed as: WILLIAM E GECEQICZ | 11113 LAKESIDE VISTA DR RIVERVIEW, FL 33569 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| FRANCISCO JAVIER RUIZ3 | 10102 COURTNEY OAKS CIR APT 20 TAMPS, FL 33619 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| MARGARITA MACIAS-CHARBONIER3 | 3649 LANA CIR TALLAHASSEE, FL 32308 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| EM PROPERTY & CASUALTY LLC3 | 13500 SW 88TH ST STE 287 MIAMI, FL 33186 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| THE FAMILY INSURANCE DISCOUNT3 | 12010 SW 135TH TERRACE MIAMI, FL 33186 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| ELBA HERNANDEZCAMBRELEN & OTHER3 Filed as: ELBA M HERNANDEZCAMBRLEN | 1231 PENSACOLA CT KISSIMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| KRISTIN ANN DECOU3 | 751 ROBIN GLENN RD BEAUMONT, CA 92223 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ADAMS BENEFIT CORPORATION3 | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $852 | $5K | 17.07% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $305 | $0 | $305 | 1.15% |
| ADAMS BENEFIT CORPORATION3 | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $825 | $4K | 16.89% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $339 | $0 | $339 | 1.32% |
| ADAMS BENEFIT CORPORATION3 Filed as: ADAMS BENEFIT CORP | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | DELTA DENTAL INSURANCE COMPANY | $2K | $0 | $2K | 7.32% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR STE 400S DALLAS, TX 75251 | DELTA DENTAL INSURANCE COMPANY | $370 | $789 | $1K | 5.00% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP, LLC | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | DELTA DENTAL INSURANCE COMPANY | $635 | $0 | $635 | 2.74% |
| ADAMS BENEFIT CORPORATION3 | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $719 | $4K | 16.61% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE STE 100 PORTLAND, OR 97223 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $348 | $0 | $348 | 1.51% |
| ADAMS BENEFIT CORPORATION3 | 301 E YAMATO RD STE 1200 BOCA RATON, FL 33431 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $366 | $2K | 14.22% |
| THE PARTNERS GROUP3 Filed as: THE PARTNERS GROUP LTD | 11850 SW 67TH AVE STE 100 PROTLAND, OR 97223 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $497 | $0 | $497 | 2.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 39-1995276 ADMIN | Claims processing Service code 12 | — | $129K |
| ADAMS BENEFIT EIN 65-0181733 BROKER | Insurance agents and brokers Service code 22 | — | $96K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $37K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $12K |
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 | 218 | 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. |
| Total participants (= "Plan participants" tile) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 31 | $526K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 210 | $198K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 210 | $175K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $23K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH UNIMERICA INSURANCE COMPANY | 218 | $407K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 150 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.