| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVENUE SUITE 750 WINTER PARK, FL 327895552 | BLUE CROSS BLUE SHIELD OF FLORIDA | $53K | — | $53K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVE STE 750 WINTER PARK, FL 327895552 | HEALTH OPTIONS, INC. | $41K | — | $41K | 5.00% |
| DREW E SAMELSON3 | 346 TRISMEN TERRACE WINTER PARK, FL 32789 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $27K | — | $27K | 11.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVE STE 750 WINTER PARK, FL 32789 | FLORIDA COMBINED LIFE | $9K | — | $9K | 10.74% |
| DREW E SAMELSON3 | 346 TRISMEN TERRACE WINTER PARK, FL 32789 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 1560 ORANGE AVE STE 750 WINTER PARK, FL 32789 | BLUECROSS BLUESHIELD OF FLORIDA | $14K | — | $14K | 999.86% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 63 | $1.9M |
| Dental | FLORIDA COMBINED LIFE | 101 | $87K |
| Vision | BLUECROSS BLUESHIELD OF FLORIDA | 97 | $1K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $248K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $248K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 134 | $230K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 63 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.