| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $2K | $6K | 5.78% |
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.49% |
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 11.24% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 10.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS INC EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Other services; Claims processing Service code 12 | — | $95K |
| CLARK & LAVEY BENEFITS SOLUTIONS EIN 04-3348257 BROKER/CONSULTANT | Consulting (general) Service code 16 | — | $89K |
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 | 291 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 291 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 290 | $111K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 291 | $47K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 291 | $47K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 159 | $801K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.