| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | P.O. BOX 11177 SOUTH BEND, IN 466340177 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $9K | $30K | 7.16% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES INC. | 1250 SOUTH CAPITAL OF TEXAS HWY BLDG 2, SUITE 125 AUSTIN, TX 787466446 | METROPOLITAN LIFE INSURANCE COMPANY | $260 | — | $260 | 0.06% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | P.O. BOX 11177 SOUTH BEND, IN 46634 | SYMETRA LIFE INSURANCE COMPANY | $33K | $5K | $38K | 18.04% |
| WORKPLACE SOLUTIONS, INC.3 Filed as: WORKPLACE SOLUTIONS INC. | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $53K | $8K | $60K | 31.54% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 SOUTH MAIN STREET SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $4K | $29K | 15.07% |
| BEAU DAVID BOUDREAUX3 Filed as: BEAU D. BOUDREAUX | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.62% |
| WORKPLACE SOLUTIONS, INC.3 Filed as: WORKPLACE SOLUTIONS INC. | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30K | $4K | $34K | 36.30% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | 130 SOUTH MAIN STREET SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14K | $1K | $15K | 16.28% |
| BEAU DAVID BOUDREAUX3 Filed as: BEAU D. BOUDREAUX | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.05% |
| GIBSON INSURANCE AGENCY, INC.3 Filed as: GIBSON INSURANCE AGENCY INC. | P.O. BOX 11177 SOUTH BEND, IN 46634 | ANTHEM INSURANCE COMPANIES, INC. | — | $1K | $1K | 1.90% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET SUITE 400 SOUTH BEND, IN 46634 | NATIONWIDE LIFE INSURANCE COMPANY | $277 | — | $277 | 14.99% |
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 | 943 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 953 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,197 | $425K |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 1,715 | $68K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 943 | $208K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 943 | $208K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 1,715 | $68K |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 943 | $494K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,715 | — |
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.