| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 8.38% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R. SHIELS & ASSOC. INC. | 9200 MONTGOMERY RD., BLDG. E STE. #17B CINCINNATI, OH 45242 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $867 | $4K | 7.36% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | P.O. BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $867 | $867 | 1.57% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 | 9200 MONTGOMERY RD., BLDG. E STE. #17B CINCINNATI, OH 45242 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.82% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 7.37% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | P.O. BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $815 | $815 | 3.13% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $876 | $876 | 8.05% |
| DENNIS R. SHIELS & ASSOCIATES INC.3 Filed as: DENNIS R SHIELS & ASSOCIATES, INC. | 9200 MONTGOMERY ROAD, BLDG. E STE. #17B CINCINNATI, OH 45242 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $772 | — | $772 | 7.09% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | P.O. BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $341 | $341 | 3.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORNERSTONE BENEFITS EIN 31-1066968 NONE | Insurance brokerage commissions and fees Service code 53 | — | $52K |
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 NONE | Contract Administrator; Other services; Insurance brokerage commissions and fees Service code 13 | — | $50K |
| MULTIPLAN INC. EIN 13-3068979 NONE | Contract Administrator; Other services; Insurance brokerage commissions and fees Service code 13 | — | $6K |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 137 | $55K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 121 | $11K |
| Stop-loss / reinsurancereinsurance | BERKLEY ACCIDENT & HEALTH INSURANCE | 119 | $293K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 158 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.