| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL & ASSOCIATES, INC. | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 322564839 | BLUE CROSS BLUE SHIELD OF FLORIDA | $34K | — | $34K | 5.00% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL & ASSOCIATES | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 322564839 | BLUE CROSS BLUE SHIELD OF FLORIDA | $18K | — | $18K | 5.00% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL & ASSOCIATES, INC. | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 322562873 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 6.34% |
| TERESA WEST4 | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $6K | — | $6K | 16.96% |
| GREEN HAZEL ASSOCIATES INC3 Filed as: GREEN-HAZEL & ASSOCIATES, INC. | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE | $3K | — | $3K | 9.34% |
| DWIGHT L PIERCE3 Filed as: DWIGHT PIERCE | C/O BENEFITS SERVICES GROUP INC 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $2K | — | $2K | 6.71% |
| THOMAS W COOPER3 Filed as: THOMAS W. COOPER | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $197 | — | $197 | 0.55% |
| MARK FALBO3 | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $100 | — | $100 | 0.28% |
| DAVID B PHILLIPS3 Filed as: DAVID B. PHILLIPS | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $71 | — | $71 | 0.20% |
| ROSS LEHMAN3 | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $70 | — | $70 | 0.20% |
| ANDREW D KOWN4 Filed as: ANDREW KWON | PO BOX 40542 CINCINNATI, OH 452400542 | AMERICAN HERITAGE LIFE | $52 | — | $52 | 0.15% |
| WILLIAM M MCMULLEN3 Filed as: WILLIAM M. MCMULLEN | PO BOX 1321 ALEXANDER CITY, AL 35011 | AMERICAN HERITAGE LIFE | $32 | — | $32 | 0.09% |
| MELISSA E KLIPP3 Filed as: MELISSA E. KLIPP | 11681 LOIS JERRY ROAD JACKSONVILLE, FL 32258 | AMERICAN HERITAGE LIFE | $15 | — | $15 | 0.04% |
| WILLIAM PATRICK DOSTALER Filed as: WILLIAM H FORD | 8833 PERIMETER PARK BLVD STE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $5 | — | $5 | 0.01% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL & ASSOCIATES, INC. | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| DWIGHT L PIERCE3 Filed as: DWIGHT PIERCE | 8833 PERIMETER PARK BLVD SUITE 802 JACKSONVILLE, FL 32216 | AMERICAN HERITAGE LIFE | $783 | — | $783 | 6.86% |
| GREENE-HAZEL & ASSOCS INC3 Filed as: GREENE-HAZEL ASSOCIATES, INC. | 10739 DEERWOOD PARK BLVD SUITE 200 JACKSONVILLE, FL 32256 | AMERICAN HERITAGE LIFE | $336 | — | $336 | 2.95% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 161 | $453K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 99 | $31K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 99 | $31K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF FLORIDA | 104 | $671K |
| Other(2 contracts) | AMERICAN HERITAGE LIFE | 71 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.