| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $30K | $0 | $30K | 2.34% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $21K | $0 | $21K | 1.64% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $41 | $28K | 12.81% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $12K | $12K | 5.50% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $2K | $9K | 3.91% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | PO BOX 901 NAPERVILLE, IL 60566 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 2.88% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.35% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $41 | $3K | 1.18% |
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST, SUITE 300 BLUE BELL, PA 19422 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $253 | $253 | 0.12% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. AND JENNON CARUTH | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $247 | $6K | 18.81% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $41 | $2K | 7.73% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.49% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | PO BOX 901 NAPERVILLE, IL 60566 | METROPOLITAN LIFE INSURANCE COMPANY | $739 | $148 | $887 | 2.89% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $721 | $41 | $762 | 2.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $166 | $166 | 0.54% |
| USI INSURANCE SERVICES LLC3 | 1787 SENTRY PARKWAY WEST, SUITE 300 BLUE BELL, PA 19422 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $14 | $14 | 0.05% |
| JENNON CARUTH3 | 7825 WASHINGTON AVENUE, SUITE 710 MINNEAPOLIS, MN 55439 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 18.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $103 | $2K | 10.55% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.36% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $573 | $147 | $720 | 3.74% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | PO BOX 901 NAPERVILLE, IL 60566 | METROPOLITAN LIFE INSURANCE COMPANY | $458 | $92 | $550 | 2.86% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $383 | $41 | $424 | 2.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC & OTHERS | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $48 | $48 | 0.25% |
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 | 203 | 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) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 270 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $220K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $220K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $220K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $220K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $220K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF WISCONSIN | 270 | $1.3M |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 332 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.