| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC INC | — | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $21K | — | $21K | 5.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $5K | $18K | 10.31% |
| OPTIMAL BENEFITS INSURANCE SERVICES3 Filed as: OPTIMAL BENEFITS PLLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 3.57% |
| OPTIMAL BENEFITS INSURANCE SERVICES3 Filed as: OPTIMAL BENEFITS PLLC | 4435 EAST CHANDLER BOULEVARD SUITE 200 PHOENIX, AZ 85048 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | — | $13K | 11.84% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 6.01% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 4.92% |
| OPTIMAL BENEFITS INSURANCE SERVICES3 Filed as: OPTIMAL BENEFITS PLLC | 4435 EAST CHANDLER BOULEVARD SUITE 200 PHOENIX, AZ 85048 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 19.17% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $554 | $148 | $702 | 5.32% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $633 | $633 | 4.79% |
| OPTIMAL BENEFITS INSURANCE SERVICES3 Filed as: OPTIMAL BENEFITS PLLC | 4435 EAST CHANDLER BOULEVARD SUITE 200 PHOENIX, AZ 85048 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 19.61% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $383 | $111 | $494 | 5.29% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $458 | $458 | 4.90% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 8337 WEST SUNSET ROAD LAS VEGAS, NV 89113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | — | $290 | 4.81% |
| HOLLERN & ASSOCIATES INCORPORATED3 | 9795 GATEWAY DRIVE ROOM 110 RENO, NV 89521 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $191 | — | $191 | 3.17% |
| JENNIFER WELLER3 | 1350 NORTH TOWN CENTER DRIVE LAS VEGAS, NV 89144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $118 | — | $118 | 1.96% |
| PATHWAY INSURANCE INC3 | PO BOX 881 DRIGGS, ID 83422 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.35% |
| CHIMIENTI & ASSOCIATES3 | 3130 WEST MAIN VISALIA, CA 93291 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.22% |
| TAMMY VAN HOUTEN-THOMPSON3 | 8693 TARA HILL AVENUE LAS VEGAS, NV 89148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.18% |
| STEVEN B POLK INC3 | 9827 KINDLE ROCK COURT LAS VEGAS, NV 89149 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.13% |
| CHRISTINA D POLK INC3 | 8972 ECHO RIDGE DRIVE LAS VEGAS, NV 89117 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 87 | $567K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $108K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $108K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $114K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $114K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $108K |
| Prescription drug | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 87 | $390K |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 219 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.