| 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 | $4K | — | $4K | 4.48% |
| HAYS COMPANIES, INC.3 | 220 SOUTH RIDGEWOOD AVENUE DAYTONA BEACH, FL 32114 | HUMANA INSURANCE COMPANY | $16 | $0 | $16 | 0.02% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | HUMANA INSURANCE COMPANY | -$5 | $0 | -$5 | -0.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $5K | $17K | 16.78% |
| MJ INSURANCE3 Filed as: MICHAEL G. BOYCE AND VARIOUS AGENTS | 518 TENNESSEE AVENUE SAINT CLOUD, FL 34769 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $1K | $7K | 12.67% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMEE, FL 34744 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 7.77% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 6.95% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 4.86% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH, LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $907 | $2K | 4.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 | 2290 LUCIEN WAY MAITLAND, FL 32751 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $42 | $2K | 3.90% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON Y. BUCZKOWSKI | 204 COVERED BRIDE DRIVE OCOEE, FL 34761 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $780 | $666 | $1K | 2.79% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | THE PAUL REVERE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 7.04% |
| DEBRA DAIGLE AMOEDO3 | 12750 GRECO DRIVE ORLANDO, FL 32824 | THE PAUL REVERE LIFE INSURANCE COMPANY | $6 | — | $6 | 4.23% |
| CALVON Y BUCZKOWSKI3 Filed as: CALVON BUCZKOWSKI AND OTHER AGENTS | 204 COVERED BRIDE DRIVE OCOEE, FL 34761 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $2 | $5 | 3.52% |
| SARAH WEYMOUTH3 Filed as: SARAH WEYMOUTH, LLC | 107 OCEAN TERRACE INDIALANTIC, FL 32903 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 2.11% |
| COLLEEN ODONNELL PRUITT3 | 4937 WANSLEY DRIVE ORLANDO, FL 32812 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 1.41% |
| WORKSITE BENEFITS SOLUTION LLC3 Filed as: WORKSITE BENEFITS SOLUTION, LLC | 2622 WYMAN CIRCLE KISSIMEE, FL 34744 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 1.41% |
| JENNIFER WEYMOUTH RESMONDO3 Filed as: JENNIFER WEYMOUTH LLC | 2940 OAKTREE DRIVE KISSIMMEE, FL 34744 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 1.41% |
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 | 273 | 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) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 167 | $100K |
| Vision | HUMANA INSURANCE COMPANY | 167 | $100K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $99K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $99K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $99K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 273 | $151K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.