| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMBRIDGE LIFE BROKERAGE LLC3 | 44 WASHINGTON ST # 1099 MORRISTOWN, NJ 07960 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 17.85% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $5K | $5K | 9.80% |
| GIS BENEFITS INC DBA BOON CHAPMAN3 | 9401 AMBERGLEN BLVD BLDG 1 STE AUSTIN, TX 78729 | PRINCIPAL LIFE INSURANCE COMPANY | — | $395 | $395 | 0.85% |
| CAMBRIDGE LIFE BROKERAGE LLC3 | 875 AVENUE OF THE AMERICAS STE 801 NEW YORK, NY 10001 | EQUITABLE | $2K | — | $2K | 15.05% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 BLDG 1, SUITE 100 AUSTIN, TX 78766 | EQUITABLE | — | $448 | $448 | 4.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAMBRIDGE LIFE BROKERAGE, LLC EIN 45-2642901 BROKER | Contract Administrator; Direct payment from the plan; Insurance agents and brokers; Other services Service code 13 | — | $44K |
| ALLIED BENEFIT SYSTEMS, LLC EIN 36-3086057 TPA | Other services; Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $40K |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 PPO | Other services; Direct payment from the plan Service code 49 | — | $17K |
| SUN LIFE ASSURANCE OF CANADA EIN 38-1082080 DENTAL PPO ASO | Contract Administrator; Claims processing Service code 12 | — | $9K |
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 100 | $47K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 116 | $58K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 100 | $47K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 100 | $47K |
| Stop-loss / reinsurancereinsurance | SUN LIFE OF CANADA | 88 | $431K |
| Other | EQUITABLE | 116 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.