| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $10K | — | $10K | 9.93% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $459 | $2K | 6.14% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $354 | $2K | 6.10% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD. STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $132 | $132 | 0.41% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $898 | — | $898 | 10.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $449 | $90 | $539 | 6.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD. STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $36 | $36 | 0.40% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $857 | — | $857 | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $429 | $97 | $526 | 6.13% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD. STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $27 | $27 | 0.31% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $843 | — | $843 | 15.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD BLDG 1 SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $281 | — | $281 | 5.00% |
| MARK METTILLE3 | C/O GROUP INDURANCE SVCS INC 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $281 | — | $281 | 5.00% |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HIGHMARK, INC. | 395 | $96K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 158 | $13K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $40K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 108 | $32K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 99 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 395 | — |
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.