| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREEN HAZEL ASSOCIATES INC3 | 10739 DEERWOOD PARK BLVD JACKSONVILLE, FL 32256 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | — | $25K | 8.94% |
| GREEN HAZEL ASSOCIATES INC3 | 10739 DEERWOOD PARK BLVD, SUITE 200 JACKSONVILLE, FL 32256 | AETNA LIFE INSURANCE CO | $23K | — | $23K | 10.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF SOUTH LTD. | 10739 DEERWOOD PARK BLVD, SUITE 200 JACKSONVILLE, FL 32256 | AETNA LIFE INSURANCE CO | $10K | — | $10K | 4.97% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBECK STREET, SUITE 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 9.55% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.49% |
| GREEN HAZEL ASSOCIATES INC3 | 10739 DEERWOOD PARK BLVD, SUITE 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $880 | — | $880 | 2.82% |
| BENEFITS TECHNOLOGIES LLC3 | 1200 E TAFT AVE SAPULPA, OK 74066 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $60 | — | $60 | 0.19% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBECK STREET, SUITE 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 12.26% |
| GREEN HAZEL ASSOCIATES INC3 | 10739 DEERWOOD PARK BLVD, SUITE 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.80% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $960 | — | $960 | 3.23% |
| BENEFITS TECHNOLOGIES LLC3 | 1200 E TAFT AVE SAPULPA, OK 74066 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $108 | — | $108 | 0.36% |
| ROBERT L GOBLE3 Filed as: ROBERT P HARLING | PO BOX 10295 GREENVILLE, SC 29603 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | — | $46 | 0.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHEILD OF FL IN EIN 59-2015694 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 4800 DEARWOOD CAMPUS PARKWAY JACKSONVILLE, FL 32246 | $331K |
| GREENE-HAZEL & ASSOCIATES, INC EIN 59-2447356 BROKER | Other commissions Service code 55 | 10739 DEERWOOD PARK BLVD JACKSONVILLE, FL 32256 | $25K |
| TELADOC PA EIN 20-1020949 PROVIDER | Accounting (including auditing) Service code 10 | 1945 LAKEPOINTE DRIVE LEWISVILLE, TX 75057 | $11K |
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 | 749 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 749 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. | 533 | $208K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 998 | $278K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 998 | $278K |
| Life insurance | AETNA LIFE INSURANCE CO | 749 | $210K |
| Short-term disability(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 749 | $271K |
| Long-term disability | AETNA LIFE INSURANCE CO | 749 | $210K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. | 533 | $208K |
| Other(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 749 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 998 | — |
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.