| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY | $67K | $2K | $69K | 4.10% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $13K | $0 | $13K | 12.20% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | 9401 AMBERGLEN BOULEVARD BUILDING 1 AUSTIN, TX 78729 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $13K | $0 | $13K | 12.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10177 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $11K | $0 | $11K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $2K | $2K | 1.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10177 | FIRST UNUM LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.26% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $915 | $915 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $631 | $4K | 12.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $348 | $2K | 5.93% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2 | $2 | 0.01% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 139 | $1.7M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 84 | $110K |
| Vision | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 84 | $110K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 114 | $73K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 114 | $73K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 139 | $1.7M |
| Other(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 114 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.