| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 16.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.57% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | P O BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $948 | $948 | 5.00% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 13.13% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | P O BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $869 | $869 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $761 | $761 | 4.38% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 65.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $529 | — | $529 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN ADMINISTRATORS, INC. | 9401 AMBERGLEN BLVD. SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $529 | $529 | 5.00% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 65.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $337 | — | $337 | 5.01% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN ADMINISTRATORS, INC. | 9401 AMBERGLEN BLVD. SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $337 | $337 | 5.01% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL | 210 | $0 |
| Vision | PRINCIPAL | 210 | $0 |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $19K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 78 | $17K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 167 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.