| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GULF SOUTH LTD | 10739 DEERWOOD PARK BLVD 200 JACKSONVILLE, FL 32256 | AETNA LIFE INSURANCE CO. | $34K | — | $34K | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 32256 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | — | $24K | 10.87% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBACK ST 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 13.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.80% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $509 | — | $509 | 1.34% |
| US BENTEC WORKPLACE SOLUTIONS3 | 99 WOOD AVENUE SOUTH ST 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $190 | — | $190 | 0.50% |
| ROGERS BENEFIT GROUP INC3 Filed as: THOMAS ROGERS | 1119 COPPER FIELD CIRCLE MACCLENNY, FL 32603 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | — | $37 | 0.10% |
| BEST WORKSITE BENEFITS INC3 | 2771 MONUMENT RD UNIT 327 JACKSONVILLE, FL 32225 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| ROBERT VICTOR WOERNER II3 Filed as: ROBERT V WOERNER II | 2258 MARSH HAWK LN APT 1384 FLEMING ISLAND, FL 32003 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 8.71% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBECK ST SUITE 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 9.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 10739 DEERWOOD PARK BLVD 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.77% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $834 | — | $834 | 2.66% |
| US BENTEC WORKPLACE SOLUTIONS3 | 99 WOOD AVENUE SOUTH ST 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $106 | — | $106 | 0.34% |
| ROGERS BENEFIT GROUP INC3 Filed as: THOMAS RODGERS | 1119 COPPERFIELD CIRCLE MACCLENNY, FL 32063 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $53 | — | $53 | 0.17% |
| BEST WORKSITE BENEFITS INC3 | 2771 MONUMENT RD UNIT 327 JACKSONVILLE, FL 32225 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.06% |
| RXBENEFITS, INC.5 | 3700 COLONNADE PKWY, STE 600 BIRMINGHAM, AL 35243 | RX BENEFITS, INC | — | $8K | $8K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF FL EIN 59-2015694 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 4800 DEERWOOD CAMPUS PKWY JACKSONVILLE, FL 32246 | $288K |
| HUB INTERNATIONAL GULF SOUTH LMTD EIN 64-0691633 BROKER | Other commissions Service code 55 | 10739 DEERWOOD PARK BLVD JACKSONVILLE, FL 32256 | $0 |
| TELEDOC PA EIN 20-1020949 PROVIDER | Accounting (including auditing) Service code 10 | 1945 LAKEPOINTE DRIVE LEWISVILLE, TX 75057 | $0 |
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 | 757 | 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) | 757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC | 516 | $382K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 958 | $220K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 958 | $37K |
| Life insurance | AETNA LIFE INSURANCE CO. | 757 | $225K |
| Short-term disability(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 757 | $294K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 757 | $225K |
| Prescription drug | RX BENEFITS, INC | 551 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC | 516 | $382K |
| Other(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 757 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 958 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.