| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATION LIFE AGENCY | PO BOX 5190 BLOOMINGTON, IL 617025190 | BLUECROSS BLUESHEILD OF ILLINOIS | $30K | — | $30K | 4.00% |
| PRIME GROUP INSURANCE SERVICES, INC3 Filed as: PRIME GROUP INS SERVICES, INC | 5215 W LAUREL ST STE 100 TAMPA, FL 336071728 | HEALTH OPTIONS, INC. | $35K | — | $35K | 5.00% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATION LIFE AGENCY L | PO BOX 5190 BLOOMINGTON, IL 617025190 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | — | $20K | 10.87% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 4.94% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $16 | $8K | 4.56% |
| PRIMEGROUP INSURANCE SERVICES3 Filed as: PRIMEGROUP INS SERVICES INC 45392 | 5402 W LAUREL ST STE 220 TAMPA, FL 336071726 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | — | $13K | 12.16% |
| PRIME GROUP INSURANCE SERVICES, INC3 Filed as: PRIME GROUP INS SERVICES, INC | 5215 W LAUREL ST STE 100 TAMPA, FL 336071728 | BLUE CROSS BLUE SHIELD OF FLORIDA | $4K | — | $4K | 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 | 384 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHEILD OF ILLINOIS | 159 | $828K |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Vision(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Prescription drug | HEALTH OPTIONS, INC. | 104 | $694K |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 417 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 417 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.