| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAMPMAN BENEFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $1K | $7K | 19.10% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $467 | $467 | 1.28% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 575 E SWEDESFORD ROAD SUITE 200 WAYNE, PA 190871613 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $180 | $180 | 0.49% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 772 LITITZ PIKE LITITZ, PA 175437314 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $19 | $19 | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
| ASSURED PARTNERS (CENTRAL PA) EIN 30-0837157 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $2K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 56 | 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) | 56 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 25 | $179K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 56 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 56 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.