| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOUNDATION RISK PARTNERS CORP3 | 147 AVENUE C SW STE 101 WINTER HAVEN, FL 33880 | BLUE CROSS BLUE SHIELD OF FLORIDA | $33K | — | $33K | 5.00% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | 500 W 13TH ST FORT WORTH, TX 76102 | BLUE CROSS BLUE SHIELD OF FLORIDA | $14K | — | $14K | 5.00% |
| FOUNDATION RISK PARTNERS CORP | DBA ACENTRIA INSURANCE WAUCHULA, FL 33873 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 7.92% |
| WORKSITE BENEFITS SOLUTION LLC | 2622 WYMAN CIR KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $4K | $7K | 4.75% |
| CALVON Y BUCZKOWSKI | 204 COVERED BRIDGE DR OCOEE, FL 34761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 1.72% |
| SARAH WEYMOUTH Filed as: SARAH WEYMOUTH LLC | 107 OCEAN TER INDIALANTIC, FL 32903 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $827 | $2K | 1.64% |
| JENNIFER WEYMOUTH RESMONDO Filed as: JENNIFER WEYMOUTH LLC | 2940 OAKTREE DR KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $478 | $2K | 1.32% |
| SHIRLEY B DRAKE | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $14 | $2K | 1.32% |
| COLLEEN ODONNELL PRUITT | 4937 WANSLEY DR ORLANDO, FL 32812 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $81 | $2K | 1.22% |
| WORKSITE AMERICA LLC | 14141 46TH ST N STE 1209 CLEARWATER, FL 33762 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $406 | $2K | 1.10% |
| MICHAEL G BOYCE | 518 TENNESSEE AVE SAINT CLOUD, FL 34769 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $24 | $1K | 0.78% |
| DEBRA DAIGLE AMOEDO | 12750 GRECO DR ORLANDO, FL 32824 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $3 | $1K | 0.69% |
| COLLETTE G BOISVERT | 349 CENTRAL ST MANCHESTER, NH 03103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $999 | $5 | $1K | 0.67% |
| PATRICIA M CARDUCCI | 4784 SIMCOE ST PALM HARBOR, FL 34683 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $719 | — | $719 | 0.48% |
| LIZBETH RAMON | 16128 APPENNINE DR BROOKSVILLE, FL 34601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $391 | $49 | $440 | 0.29% |
| JENNIFER LOUISE WENKE | 9040 TOWN CENTER PKWY LAKEWOOD RANCH, FL 34202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $373 | $41 | $414 | 0.27% |
| EDWARD THOMAS CARPENTER | 67 LAKE HENRY DR LAKE PLACID, FL 33852 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $380 | $25 | $405 | 0.27% |
| KENNETH A HOLDER | 870 GREENSHANK DR HAINES CITY, FL 33844 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $387 | $7 | $394 | 0.26% |
| HIGGINBOTHAM INS AGENCY INC Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC | 500 W 13TH ST FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $343 | $20 | $363 | 0.24% |
| LUCAS GARTENMAYER | 39051 12TH AVE ZEPHYRHILLS, FL 33542 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $299 | $40 | $339 | 0.23% |
| ANGEL GABRIEL VELAZQUEZ-DIAZ | 2022 ESTANCIA CIR STE 6 KISSIMMEE, FL 34741 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $71 | $250 | 0.17% |
| CARMEN SOFIA PILATO | 6824 NW 107TH PL DORAL, FL 33178 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $199 | — | $199 | 0.13% |
| KELLY H ALLEN | 2 CAYUSE CT PALM COAST, FL 32137 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $182 | — | $182 | 0.12% |
| SHELBY GROUP INC | 3496 E WOODMONT WAY PALM HARBOR, FL 32163 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 0.10% |
| OMAR ENRIQUE FIGUEROA | 3424 DOUGLAS CT KISSIMMEE, FL 34746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $112 | $23 | $135 | 0.09% |
| CHOICE BENEFITS SOLUTIONS LLC | 11399 81ST PL SEMINOLE, FL 33772 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $35 | $55 | 0.04% |
| MARIELENA HERRERA | 12338 DORA TRL PARRISH, FL 34219 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.03% |
| VIVIAN LORENA CLIFTON | 7349 ULMERTON RD LOT 275 LARGO, FL 33771 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.03% |
| LIZBETH RAMON Filed as: LIZBETH NUNEZ | 16128 APPENNINE DR BROOKSVILLE, FL 34601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $1 | $25 | 0.02% |
| JOHN ANTHONY CARREIRO III Filed as: JOHN ANTHONY CARREIRO | 11750 CAPRI CIR S APT 3 TREASURE ISLAND, FL 33706 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| CLEARON K PALMER | 984 TRAMELLS TRL KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.01% |
| GASPARD EMPLOYEE BENEFITS LLC | 102 RED OAK LN BRANDON, MA 39042 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| PARAGON ADVISORY LLC | 2592 MAISTO PL THE VILLAGES, FL 32163 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| ROBBINS RESEARCH AND PLANNING INC | 11012 COVINGTON WAY OXFORD, MA 38655 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| ENROLLMENT ALLIANCE LLC | 1302 N 19TH ST STE 150 TAMPA, FL 33605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| HOLLINGSWORTH BENEFITS SOLUTIONS | 2 WIGEON LN RAYMOND, MA 39154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| FOUNDATION RISK PARTNERS CORP | 147 AVENUE C SW STE 101 WINTER HAVEN, FL 33880 | BLUECROSS BLUESHIELD OF FLORIDA INC | $1K | — | $1K | 8.31% |
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 | 121 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF FLORIDA | 121 | $941K |
| Vision | BLUECROSS BLUESHIELD OF FLORIDA INC | 92 | $15K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 91 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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.