| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $107 | $12K | 9.40% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 5.07% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $107 | $2K | 18.32% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $358 | $98 | $456 | 5.43% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUDTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $358 | $358 | 4.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $102 | $102 | 1.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $107 | $1K | 18.20% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $329 | $95 | $424 | 5.42% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $329 | $329 | 4.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $97 | $97 | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $107 | $1K | 18.50% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $283 | $83 | $366 | 5.46% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $283 | $283 | 4.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $84 | $84 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MANAGEMENT SERVICE EIN 81-0391256 ADMIN | Claims processing Service code 12 | — | $46K |
| GALLAGHER BENEFITS SERVICES INC EIN 36-4291971 BROKER | Insurance agents and brokers Service code 22 | — | $31K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $26K |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 ADMIN | Claims processing Service code 12 | — | $21K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $7K |
| MY TELEMEDICINE INC DBA LYRIC EIN 47-3600495 ADMIN | Claims processing Service code 12 | — | $5K |
| EMPLOYER'S HEALTH COALITION EIN 71-0786360 ADMIN | Claims processing Service code 12 | — | $1K |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 494 | $128K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 494 | $128K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 494 | $128K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 494 | $128K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 227 | $162K |
| Other(4 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 494 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.