| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $19K | — | $19K | 5.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $3K | $11K | 5.06% |
| 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 | $8K | — | $8K | 3.62% |
| CAPITAL GROUP BENEFITS LLC3 Filed as: CAPITAL GROUP BENEFITS & FINANCIAL | 7001 HERITAGE VILLAGE PLAZA STE 100 GAINESVILLE, VA 20155 | UNITED HEALTHCARE INSURANCE COMPANY | $3K | $10 | $3K | 3.97% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE ST. MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $933 | $145 | $1K | 9.71% |
| 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 | $723 | — | $723 | 6.51% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $362 | $362 | 3.26% |
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 | 570 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NATIONWIDE LIFE INSURANCE COMPANY | 261 | $669K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 909 | $279K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 909 | $279K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $317K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $317K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $317K |
| Prescription drug | NATIONWIDE LIFE INSURANCE COMPANY | 261 | $669K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 570 | $328K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 909 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.