| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | $11K | $54K | 5.98% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS AND FIN SVCS | 7001 HERITAGE VILLAGE PLZ STE 100 GAINESVILLE, VA 20155 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | — | $43K | 4.79% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE. STE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | -$9K | — | -$9K | -1.05% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFIT AND FIN SVCS | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $19K | $43K | 5.85% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 0.30% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS & FIN SVCS | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | — | $19K | 10.00% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS AND FIN SERV | 7001 HERITAGE VILLAGE PLZ STE 100 GAINESVILLE, VA 20155 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $628 | $27K | 41.91% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $815 | $4K | 6.27% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS AND FIN SVCS | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $402 | $14K | 38.95% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $490 | $2K | 6.60% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $158 | — | $158 | 10.03% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $16 | $16 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL GROUP BENEFITS EIN 54-2016867 BROKER | Insurance agents and brokers Service code 22 | — | $262K |
| ALLIED BENEFIT SYSTEMS, LLC EIN 36-3086057 TPA | Contract Administrator Service code 13 | — | $205K |
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 PPO | Other services Service code 49 | — | $106K |
| BENEFIT BRAINSTORM, INC. EIN 27-1092669 OTHER | Other fees Service code 99 | — | $72K |
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 | 937 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 937 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF ALABAMA | 218 | $603K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,427 | $1.1M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,427 | $902K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 937 | $732K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 937 | $732K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 937 | $732K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ALABAMA | 46 | $352K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 546 | $1.1M |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 937 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,427 | — |
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.