| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $11K | 18.31% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $704 | $704 | 1.19% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 152125860 | METROPOLITAN LIFE INSURANCE COMPANY | — | $25 | $25 | 0.04% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $801 | $5K | 17.95% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $375 | $2K | 6.38% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $780 | $5K | 18.11% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $373 | $2K | 6.49% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $270 | $2K | 18.20% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $422 | $127 | $549 | 6.50% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $611 | $136 | $747 | 12.23% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $305 | $62 | $367 | 6.01% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $505 | $158 | $663 | 13.12% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $253 | $75 | $328 | 6.49% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $382 | — | $382 | 11.01% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD. BLDG 1, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $173 | — | $173 | 4.99% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $139 | — | $139 | 4.01% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $178 | $33 | $211 | 17.81% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $59 | $15 | $74 | 6.24% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $59K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 136 | $59K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $25K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $27K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 55 | $8K |
| Other(5 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 113 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.