| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOME OFFICE TPA PAYS COMMISSION3 | 5900 O ST LINCOLN, NE 685102234 | RELIANCEMATRIX | $9K | — | $9K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | — | $259 | $259 | 0.77% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS, INC. BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCESTANDARD LIFE INSURANCE COMPANY | — | $130 | $130 | 0.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | — | $148 | $148 | 0.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $388 | — | $388 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | — | $47 | $47 | 0.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $295 | — | $295 | 5.00% |
| MARK METTILLE3 | C/O GROUP INSURANCE SVCS INC 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $213 | — | $213 | 4.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMINISTRATOR | 9401 AMBERGLEN BLVD BLDG 1 SUITE 100 AUSTIN, TX 78729 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $213 | — | $213 | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INT MIDWEST LTD | DBA HORAN HEALTH 8044 MONTGOMERY RD ST 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $126 | — | $126 | 2.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND LLC | 8044 MONTGOMERY ROAD STE 640 CINCINNATI, OH 45236 | RELIANCESTANDARD LIFE INSURANCE COMPANY | $87 | — | $87 | 2.04% |
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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | RELIANCEMATRIX | 224 | $58K |
| Life insurance | RELIANCESTANDARD LIFE INSURANCE COMPANY | 118 | $28K |
| Short-term disability | RELIANCESTANDARD LIFE INSURANCE COMPANY | 127 | $48K |
| Long-term disability | RELIANCESTANDARD LIFE INSURANCE COMPANY | 118 | $34K |
| Other(4 contracts) | RELIANCESTANDARD LIFE INSURANCE COMPANY | 118 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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.