| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1721 MAGNAVOX WAY FORT WAYNE, IN 46804 | BLUECROSS BLUESHIELD OF ILLINOIS | $53K | $2K | $55K | 3.98% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $2K | $12K | 13.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, WA 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $6K | 6.48% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $963 | $963 | 1.09% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | $4K | $14K | 20.88% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, WA 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 157 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 241 | $88K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 241 | $88K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 60 | $69K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 60 | $69K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 60 | $69K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 157 | $1.4M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 241 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.