| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | HEALTH OPTIONS | $38K | $0 | $38K | 3.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENFIT SERVICE,S INC. | 200 SOUTH ORANGE AVENUE, SUITE 1350 ORLANDO, FL 32801 | HEALTH OPTIONS | $7K | $0 | $7K | 0.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | BLUE CROSS BLUE SHIELD OF FLORIDA | $23K | $0 | $23K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENFIT SERVICE,S INC. | 200 SOUTH ORANGE AVENUE, SUITE 1350 ORLANDO, FL 32801 | BLUE CROSS BLUE SHIELD OF FLORIDA | $5K | $0 | $5K | 0.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | FLORIDA COMBINED LIFE | $9K | $0 | $9K | 8.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | AFLAC | $5K | $17 | $5K | 9.60% |
| WANDA J. FORT3 | 6751 CABELLO DRIVE JACKSONVILLE, FL 32226 | AFLAC | $2K | $506 | $3K | 5.37% |
| JAMES FORT3 | 6751 CABELLO DRIVE JACKSONVILLE, FL 32226 | AFLAC | $949 | $695 | $2K | 3.34% |
| SHADEL & ASSOCIATES LLC3 Filed as: SHADEL AND ASSOCIATES LLC | 4801 GLENWOOD AVENUE, SUITE 200 RALEIGH, NC 27612 | AFLAC | $642 | $287 | $929 | 1.88% |
| JAMES MILLER3 Filed as: JAMES MILLER INC. | 2202 57TH STREET SE AUBURN, WA 98092 | AFLAC | $355 | $265 | $620 | 1.26% |
| MJ INSURANCE3 Filed as: JAMES B. TUBER AND VARIOUS AGENTS | 153 BLANDING BOULEVARD, SUITE 3 ORANGE PARK, FL 32073 | AFLAC | $378 | $220 | $598 | 1.21% |
| DONNETT JONES3 | 7757 ENDERVY AVENUE EAST JACKSONVILLE, FL 32244 | AFLAC | $242 | $22 | $264 | 0.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BOULEVARD SUITE 200 JACKSONVILLE, FL 32256 | USABLE LIFE | $6K | $0 | $6K | 20.79% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 | 4800 DEERWOOD CAMPUS PARKWAY SUITE DC2/2 JACKSONVILLE, FL 32246 | USABLE LIFE | $2K | $0 | $2K | 8.60% |
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 | 251 | 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) | 251 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 149 | $1.8M |
| Dental | FLORIDA COMBINED LIFE | 256 | $102K |
| Vision | VISION SERVICE PLAN | 195 | $23K |
| Life insurance | USABLE LIFE | 262 | $27K |
| Short-term disability | USABLE LIFE | 262 | $27K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 149 | $1.8M |
| Other(2 contracts, 2 carriers) | AFLAC | 262 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
No prospect flags tripped on this filing.