| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 | 300 N. BEACH ST. DAYTONA BEACH, FL 32114 | ANTHEM BLUE CROSS | $121K | — | $121K | 2.92% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS INC. | 225 WIRELESS BLVD. HAUPPAUGE, NY 11788 | ANTHEM BLUE CROSS | — | $26K | $26K | 0.63% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $34K | $8K | $41K | 20.74% |
| GIS BENEFITS INC3 Filed as: GIS BENEIFITS INC | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.06% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 800 WESTCHESTER AVE STE 302 RYE BROOK, NY 10573 | METROPOLITAN LIFE INSURANCE COMPANY | — | $51 | $51 | 0.03% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF NEW YORK INC | 6 TOWER PL ALBANY, NY 122033725 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$106 | -$106 | -0.05% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN OF NEW YORK INC. | 800 WESTCHESTER AVE STE 302 RYE BROOK, NY 10573 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $51 | $3K | 12.58% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $211 | $1K | 5.92% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 4.94% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN LONE STAR INSURANCE S | 5850 GRANITE PARKWAY STE 350 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.03% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF NEW YORK INC. | 6 TOWER PLACE ALBANY, NY 12203 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$11 | -$11 | -0.05% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 800 WESTCHESTER AVE STE 302 RYE BROOK, NY 10573 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $51 | $1K | 10.37% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $541 | $108 | $649 | 5.93% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $541 | $541 | 4.95% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN LONE STAR INSURANCE | 5850 GRANITE PARKWAY STE 350 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.03% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF NEW YORK INC. | 6 TOWER PLACE ALBANY, NY 12203 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$6 | -$6 | -0.05% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 800 WESTCHESTER AVE STE 302 RYE BROOK, NY 10573 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $51 | $1K | 10.36% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $534 | $107 | $641 | 5.94% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $534 | $534 | 4.94% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN LONE STAR INSURANCE S | 5850 GRANITE PARKWAY STE 350 PLANO, TX 75024 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.03% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN AND BROWN OF NEW YORK INC. | 6 TOWER PLACE ALBANY, NY 12203 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$6 | -$6 | -0.06% |
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 | 186 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 262 | $4.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 425 | $200K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 274 | $11K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 425 | $200K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 425 | $200K |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 425 | $241K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 425 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.