| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 24.46% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 2520 NORTHWINDS PKWAY STE 600 ALPHARETTA, GA 30009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $652 | $652 | 1.97% |
| ASSUREDPARTNERS3 Filed as: THE SIMKISS AGENCY INC | 1041 OLD CASSATT RD BERWYN, PA 19312 | RELIANCE STANDARD | $902 | $64 | $966 | 16.06% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD | $301 | $117 | $418 | 6.95% |
| BENEFIT ADVISOR SERVICES3 Filed as: BENEFIT ADVISOR | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD | $0 | $64 | $64 | 1.06% |
| ASSUREDPARTNERS3 Filed as: THE SIMKISS AGENCY INC | 2 PAOLI OFFICE PARK PO BOX 1787 PAOLI, PA 19301 | RELIANCE STANDARD | $756 | $0 | $756 | 14.99% |
| BOONE-CHAPMAN BENEFIT ADMINISTRATOR3 | 9401 AMBERGLEN BLVE STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD | $252 | $0 | $252 | 5.00% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD | $252 | $0 | $252 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SIMKISS & BLOCK EIN 23-1652791 BROKER | Insurance agents and brokers Service code 22 | — | $25K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| MERITAIN EIN 16-1264154 CARRIER | Claims processing Service code 12 | — | $8K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 104 | $33K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 104 | $33K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 104 | $33K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 48 | $94K |
| Other | RELIANCE STANDARD | 31 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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.