| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | HUMANA INSURANCE COMPANY | $5K | $0 | $5K | 4.26% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | HUMANA INSURANCE COMPANY | $0 | $2K | $2K | 2.19% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $2K | $16K | 14.53% |
| JASON SCZEPANIAK3 | 1161 HERITAGE COURT SUN PRAIRIE, WI 53590 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.14% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 4TH FLOOR BOSTON, MA 02110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $77 | $3K | 10.40% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INS. AGENCY & OTHER AGENTS | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $429 | $3K | 9.01% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 7.42% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH, LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $802 | $305 | $1K | 3.36% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER WEYMOUTH, LLC | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $387 | $75 | $462 | 1.40% |
| LIZBETH RAMON3 Filed as: LIZBETH RAMON NUNEZ | 16128 APPENNINE DRIVE BROOKSVILLE, FL 34601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $330 | $31 | $361 | 1.10% |
| COLLEEN ODONNELL PRUITT3 | 4937 WANSLEY DRIVE ORLANDO, FL 32812 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $331 | $13 | $344 | 1.05% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMMEE, FL 34744 | THE PAUL REVERE LIFE INSURANCE COMPANY | $24 | $9 | $33 | 11.26% |
| COLLETTE G BOISVERT3 Filed as: COLLETTE G. BOISVERT | 349 CENTRAL STREET MANCHESTER, NH 03103 | THE PAUL REVERE LIFE INSURANCE COMPANY | $13 | $0 | $13 | 4.44% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH, LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9 | $0 | $9 | 3.07% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 204 COVERED BRIDGE DRIVE OCOEE, FL 34761 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $3 | $6 | 2.05% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER WEYMOUTH, LLC | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $2 | $5 | 1.71% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS, LTD | 65 BURBANK ROAD SUTTON, MA 01590 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.68% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INS. AGENCY & OTHER AGENTS | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.68% |
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 | 350 | 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) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 151 | $111K |
| Vision | HUMANA INSURANCE COMPANY | 151 | $111K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $111K |
| Short-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 1 | $293 |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $111K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 350 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.