| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | BLUE CROSS BLUE SHIELD OF FLORIDA | $4K | — | $4K | 0.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 300 N BEACH ST DAYTONA BEACH, FL 32114 | BLUE CROSS BLUE SHIELD OF FLORIDA | $4K | — | $4K | 0.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | HEALTH OPTIONS | $2K | — | $2K | 3.26% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA | 300 N BEACH ST DAYTONA BEACH, FL 32114 | HEALTH OPTIONS | $361 | — | $361 | 0.77% |
| WINGATE INSURANCE GROUP, INC.3 Filed as: WINGATE INSURANCE GROUP | 155 PROFESSIONAL DR PONTE VEDRA BEACH, FL 320826217 | FLORIDA COMBINED LIFE | $2K | — | $2K | 5.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | FLORIDA COMBINED LIFE | $2K | — | $2K | 3.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 12.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC. | 220 S. RIDGEWOOD AVE #500 DAYTONA BEACH, FL 32114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $789 | — | $789 | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 12.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC | 220 S. RIDGEWOOD AVE SUITE 500 DAYTONA BEACH, FL 32114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $508 | — | $508 | 2.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 35.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC. | 220 S. RIDGEWOOD AVE #500 DAYTONA BEACH, FL 32114 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 12.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL FLORIDA | 1330 LADY STREET SUITE 202 COLUMBIA, SC 29201 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $667 | $249 | $916 | 11.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | 220 SOUTH RIDGEWOOD AVE DAYTONA BEACH, FL 32114 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $121 | — | $121 | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $653 | — | $653 | 12.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FL INC | 220 S. RIDGEWOOD AVE #500 DAYTONA BEACH, FL 32114 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $156 | — | $156 | 2.89% |
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 | 201 | 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) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 84 | $578K |
| Dental | FLORIDA COMBINED LIFE | 92 | $44K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 81 | $8K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 201 | $37K |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 61 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 212 | $19K |
| Prescription drug | HEALTH OPTIONS | 3 | $47K |
| Other(2 contracts, 2 carriers) | FLORIDA COMBINED LIFE | 201 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.