| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | — | $23K | 8.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA LOCK CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.08% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN HAZEL & ASSOCIATES INC | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 0.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 625 KENMORE AVE SE SUITE 200 GRAND RAPIDS, MI 49546 | HARTFORD LIFE AND ACCIDENT | $31K | — | $31K | 15.00% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBACK ST 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | — | $7K | 13.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 4830 WEST KENNEDY BLVD SUITE 850 TAMPA, FL 33609 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 5.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 10739 DEERWOOD PARK BLVD 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 2.08% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $420 | — | $420 | 0.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $237 | $237 | 0.45% |
| US BENTEC WORKPLACE SOLUTIONS3 | 99 WOOD AVENUE SOUTH ST 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $93 | — | $93 | 0.18% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS THOMAS | 143 CASTRO COURT ST. JOHNS, FL 32259 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | — | $20 | 0.04% |
| BEST WORKSITE BENEFITS INC3 | 2771 MONUMENT RD UNIT 327 JACKSONVILLE, FL 32225 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| ARW BENEFITS LLC3 | 210 16TH ST UNIT K ST. AUGUSTINE, FL 32080 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 6.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 16253 COLLECTION CENTER DR 40 W MADISON 4TH FL BANK OF AMERICA LOCK CHICAGO, IL 606930162 | METROPOLITAN LIFE INSURANCE COMPANY | — | $486 | $486 | 1.08% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN HAZEL & ASSOCIATES INC | 10739 DEERWOOD PARK BLVD STE 200 JACKSONVILLE, FL 322564839 | METROPOLITAN LIFE INSURANCE COMPANY | $260 | — | $260 | 0.58% |
| CREATIVE WORKSITE SOLUTIONS LLC3 | 3404 SALTERBECK ST SUITE 207 MT PLEASANT, SC 29466 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 9.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 4830 WEST KENNEDY BLVD SUITE 850 TAMPA, FL 33609 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 2.94% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 10739 DEERWOOD PARK BLVD 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $939 | — | $939 | 2.65% |
| HYLANT GROUP INC3 | 811 MADISON AVE TOLEDO, OH 43604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $617 | — | $617 | 1.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $58 | $58 | 0.16% |
| US BENTEC WORKPLACE SOLUTIONS3 | 99 WOOD AVENUE SOUTH ST 501 ISELIN, NJ 08830 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $55 | — | $55 | 0.15% |
| RXBENEFITS, INC.5 | 3700 COLONNADE PKWY, STE 600 BIRMINGHAM, AL 35243 | RX BENEFITS, INC | — | $4K | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF FL EIN 59-2015694 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 4800 DEERWOOD CAMPUS PKWY JACKSONVILLE, FL 32246 | $281K |
| 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 | 797 | 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) | 797 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC | 515 | $373K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,051 | $268K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,051 | $45K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 797 | $207K |
| Short-term disability(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 797 | $294K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 797 | $207K |
| Prescription drug | RX BENEFITS, INC | 532 | $0 |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC | 515 | $373K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 797 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,051 | — |
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.