| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | P.O. BOX 9201 AUSTIN, TX 787669201 | METROLOLITIAN LIFE INSURANCE CO | $38K | $17K | $55K | 15.32% |
| ELES ENTERPRISES INC3 | P.O. BOX 445 RIEGELSVILLE, PA 18077 | METROLOLITIAN LIFE INSURANCE CO | $11K | $0 | $11K | 2.96% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROLOLITIAN LIFE INSURANCE CO | $0 | $5K | $5K | 1.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELLPOWER INC EIN 22-3530108 NONE | Claims processing Service code 12 | — | $28K |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC- MEDICAL | 175 | $967K |
| Dental | METROLOLITIAN LIFE INSURANCE CO | 375 | $356K |
| Vision | HIGHMARK INC- VISION | 403 | $20K |
| Life insurance | METROLOLITIAN LIFE INSURANCE CO | 375 | $356K |
| Short-term disability | METROLOLITIAN LIFE INSURANCE CO | 375 | $356K |
| Long-term disability | METROLOLITIAN LIFE INSURANCE CO | 375 | $356K |
| Other | METROLOLITIAN LIFE INSURANCE CO | 375 | $356K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
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.