| 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 | $6K | $2K | $8K | 7.04% |
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $17 | $4K | 3.27% |
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 10.49% |
| GIS BENEFITS INC Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| CLARK INSURANCE3 Filed as: CLARK & LAVEY BENEFITS SOLUTIONS | 7 HENRY CLAY DRIVE MERRIMACK, NH 03054 | EYEMED VISOIN CARE | $1K | $0 | $1K | 9.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH PLANS INC EIN 04-2734278 THIRD PARTY ADMINISTRATOR | Claims processing; Other services Service code 12 | — | $93K |
| CLARK & LAVEY BENEFITS SOLUTIONS EIN 04-3348257 BROKER/CONSULTANT | Consulting (general) Service code 16 | — | $0 |
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 | 302 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 280 | $115K |
| Vision | EYEMED VISOIN CARE | 219 | $16K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 302 | $54K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 302 | $54K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 135 | $789K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
No prospect flags tripped on this filing.