| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL AND ASSOCIATES, INC. | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | AETNA HEALTH, INC. | — | $36K | $36K | 5.18% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL AND ASSOCIATES, INC. | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | AETNA LIFE INSURANCE COMPANY | $6K | $178 | $7K | 9.16% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL AND ASSOCIATES, INC. | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | PRINCIPAL LIFE INSURANCE COMPANY | $109 | — | $109 | 0.35% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW FINANCIAL | 353 NORTH CLARK STREET, SUITE 1100 CHICAGO, IL 60654 | EYEMED VISION CARE | $255 | — | $255 | 11.13% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA HEALTH, INC. | 192 | $695K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 133 | $31K |
| Vision | EYEMED VISION CARE | 47 | $2K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 143 | $72K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 143 | $72K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 143 | $72K |
| Prescription drug | AETNA HEALTH, INC. | 192 | $695K |
| Other | AETNA LIFE INSURANCE COMPANY | 143 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.