| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS | 639 EXECUTIVE PLACE SUITE 202 FAYETTEVILLE, NC 28305 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $38K | — | $38K | 5.36% |
| EBENCONCEPTS COMPANY3 | 15305 N DALLAS PARKWAY STE 800 ADDISON, TX 75001 | PRINCIPAL LIFE INSURANCE COMPANY | $41K | $12K | $53K | 17.08% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $7K | $21K | 6.88% |
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY STE 800 ADDISON, TX 75001 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | — | $11K | 18.89% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $724 | $4K | 5.94% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 4.72% |
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 | 180 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 111 | $714K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $310K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $310K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $310K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $310K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $310K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.