| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 7.52% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 5.78% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.73% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 17.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 7.16% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMSTRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 3.83% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 6.38% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $917 | $917 | 3.83% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 17.32% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 7.19% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMSTRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $774 | $774 | 3.83% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $614 | $614 | 6.42% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $552 | — | $552 | 5.77% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $366 | $366 | 3.83% |
| ENERGY INSURANCE AGENCY INC3 | PO BOX 55268 LEXINGTON, KY 40555 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $548 | — | $548 | 20.17% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMSTRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $139 | $139 | 5.12% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $38 | $38 | 1.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STAR MARKETING AND ADMINISTRATION, EIN 36-3403079 ADMIN | Other services; Claims processing; Plan Administrator Service code 12 | — | $51K |
| ENERGY INSURANCE AGENCY INC EIN 61-1004028 BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $26K |
| MULTIBENEFIT SERVICES OHIO EIN 36-4104766 ADMIN | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $10K |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 102 | $39K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 94 | $10K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 108 | $33K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 42 | $20K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 143 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.