| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | P. O. BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $1K | $7K | 18.34% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 152125860 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.76% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $446 | $446 | 1.19% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $757 | $6K | 17.28% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $433 | $2K | 6.30% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $628 | $5K | 17.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $359 | $2K | 6.14% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $284 | $2K | 17.56% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $555 | $162 | $717 | 6.46% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $170 | $1K | 21.77% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $324 | $97 | $421 | 6.50% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $824 | $158 | $982 | 16.84% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $292 | $90 | $382 | 6.55% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| MARK METTILLE3 Filed as: MARK METTILLE C/O GIS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $408 | $0 | $408 | 10.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD BUILDING 1 SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $186 | $0 | $186 | 5.01% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $148 | $0 | $148 | 3.99% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $203 | $34 | $237 | 17.54% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $68 | $19 | $87 | 6.44% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $37K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 142 | $37K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 104 | $31K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 104 | $33K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 58 | $11K |
| Other(5 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 104 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.