| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES M. CROSS3 Filed as: JAMES CAMPBELL & ASSOCIAT | 2039 CENTRE POINTE BLVD. SUITE 203 TALLAHASSEE, FL 32308 | BLUE CROSS BLUE SHIELD OF FLORIDA | $55K | — | $55K | 4.99% |
| JIM CAMPBELL3 | 2039 CENTRE POINTE BOULEVARD SUITE 203 TALLAHASSEE, FL 32317 | CAPITAL HEALTH PLAN | $16K | — | $16K | 3.01% |
| GIS BENEFITS INC3 | 2520 NORTHWINDS PARKWAY SUITE 600 ALPHARETTA, GA 30009 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $321 | $2K | 2.34% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.94% |
| GIS BENEFITS INC3 | 2520 NORTHWINDS PARKWAY SUITE 600 ALPHARETTA, GA 30009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $526 | $526 | 0.65% |
| JAMES CAMPBELL & ASSOCIATES3 | 2039 CENTRE POINTE BOULEVARD SUITE 203 TALLAHASSEE, FL 32308 | USABLE LIFE | $6K | — | $6K | 13.74% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $2K | — | $2K | 4.65% |
| JAMES CAMPBELL & ASSOCIATES3 | 2039 CENTRE POINTE BOULEVARD SUITE 203 TALLAHASSEE, FL 32308 | USABLE LIFE | $2K | — | $2K | 12.20% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $714 | — | $714 | 4.65% |
| JAMES CAMPBELL & ASSOCIATES3 | 2039 CENTRE POINTE BOULEVARD SUITE 203 TALLAHASSEE, FL 32308 | USABLE LIFE | $327 | — | $327 | 13.82% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY # DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $110 | — | $110 | 4.65% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 94 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $81K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $81K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $139K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $81K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $81K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 94 | $1.1M |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 225 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.