| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES, IN | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | BLUE CROSS BLUE SHIELD OF FLORIDA | $62K | $0 | $62K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK, GOULD & ASSOCIATES, IN | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 850121979 | PRINCIPAL LIFE INSURANCE COMPANY | $29K | $4K | $33K | 15.86% |
| SHERI KENNARD GAUL | 426 MYRTLEWOOD RD MELBOURNE, FL 32940 | AFLAC | $1K | $40 | $1K | 7.60% |
| MICHAEL S WITHROW | 4801 GLENWOOD AVE STE 200 RALEIGH, NC 27612 | AFLAC | $221 | — | $221 | 1.31% |
| SHERI KENNARD GAUL Filed as: SHERI K GAUL PA | 426 MYRTLEWOOD RD MELBOURNE, FL 32940 | AFLAC | $158 | $0 | $158 | 0.94% |
| FILIPE A COELHO | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $142 | $0 | $142 | 0.84% |
| D VICKERS & ASSOCIATES INC Filed as: D VICKERS & ASSOICATES INC | 1037 PATHFINDER WAY STE 130 ROCKLEDGE, FL 32955 | AFLAC | $130 | $9 | $139 | 0.82% |
| KENNARD-PERRI Filed as: KENNARD PERRI | 3703 DRIFTWOOD DR MELBOURNE, FL 32935 | AFLAC | $105 | $0 | $105 | 0.62% |
| CARRIE DIANE ROBERTS | PO BOX 560772 ROCKLEDGE, FL 32956 | AFLAC | $94 | $9 | $103 | 0.61% |
| NOLAN KING | 15690 W COLONIAL DR WINTER GARDEN, FL 34787 | AFLAC | $89 | $0 | $89 | 0.53% |
| RICHARD R KIMBROUGH | 6380 N PARK MEADOW WAY APT 203 BOISE, ID 83713 | AFLAC | $83 | $0 | $83 | 0.49% |
| JOSE A SCHIENEMAN | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $47 | $0 | $47 | 0.28% |
| NOLAN KING | 9961 DOWDEN RD UNIT 21112 ORLANDO, FL 32832 | AFLAC | $33 | $0 | $33 | 0.20% |
| MKF & ASSOCIATES INC | 4222 MARDEN WAY VESTAVIA, AL 35242 | AFLAC | $21 | $0 | $21 | 0.12% |
| LESLIE K KIMBROUGH | PO BOX 273488 BOCA RATON, FL 33427 | AFLAC | $9 | $0 | $9 | 0.05% |
| ASHLEY INSURANCE GROUP Filed as: ASHLEY M BOEHLER | 8325 E ANGUS DR SCOTTSDALE, AZ 85251 | AFLAC | $8 | $0 | $8 | 0.05% |
| DOUGLAS J SUCHECKI | 1224 PEACOCK AVE STE 205 COLUMBUS, GA 31906 | AFLAC | $5 | $0 | $5 | 0.03% |
| DEREK DEVANE | 3205 JERRY SMITH RD DOVER, FL 33527 | AFLAC | $4 | $0 | $4 | 0.02% |
| DENA JORDAN | 9300 HARRIS CORNERS PKWY STE 100 APT 208 CHARLOTTE, NC 28269 | AFLAC | $3 | $0 | $3 | 0.02% |
| PATRICIA ANNE REILLY | 269 E LONG CREEK CV LONGWOOD, FL 32750 | AFLAC | $3 | $0 | $3 | 0.02% |
| DAWN T SUCHECKI | 225 S WATER ST WILMINGTON, NC 28401 | AFLAC | $1 | $0 | $1 | 0.01% |
| RUBICON REGION LLC | 1862 KEYSTONE PL SCHAUMBURG, IL 60193 | AFLAC | $1 | $0 | $1 | 0.01% |
| BERNARD FALCO Filed as: BERNARD JOSEPH FALCO | 657 SHADOWMOSS CIR LAKE MARY, FL 32746 | AFLAC | $1 | $0 | $1 | 0.01% |
| ASHLEY CROOK Filed as: ASHLEY L CROOK | 3187 ESSEX PLACE DR MOBILE, AL 36695 | AFLAC | $1 | $0 | $1 | 0.01% |
| SARAH CADY | 123 STONE GABLE CIR WINTER SPRINGS, FL 32708 | AFLAC | $1 | $0 | $1 | 0.01% |
| JENNIE MOORE HAWKINS | 3216 MEDICI BLVD NEW SMYRNA BEACH, FL 32168 | AFLAC | $1 | $0 | $1 | 0.01% |
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. |
| 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 105 | $1.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $210K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $210K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $210K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $210K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 257 | $210K |
| Other | AFLAC | 19 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.