| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC | 715 S US HIGHWAY 301 TAMPA, FL 33619 | BLUE CROSS BLUE SHIELD OF FLORIDA | $52K | — | $52K | 4.12% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC | 715 S US HIGHWAY 301 TAMPA, FL 33619 | HEALTH OPTIONS | $10K | — | $10K | 3.96% |
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 6.06% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $55 | $4K | 4.28% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC. | 715 S. US HIGHWAY 301 TAMPA, FL 33619 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 18.09% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS INC, BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 15.01% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $433 | $433 | 1.99% |
| CHOICE BENEFITS INC3 | 9007 BRITTANY WAY TAMPA, FL 33619 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $539 | $539 | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $539 | $539 | 5.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $192 | $192 | 1.78% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC. | 715 S. US HIGHWAY 301 TAMPA, FL 33619 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 20.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $286 | — | $286 | 4.99% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS INC, BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $286 | $286 | 4.99% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $10 | $10 | 0.17% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC. | 715 S. US HIGHWAY 301 TAMPA, FL 33619 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $687 | — | $687 | 20.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $172 | — | $172 | 5.01% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS INC, BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TN 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $172 | $172 | 5.01% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $5 | $5 | 0.15% |
| CHOICE BENEFITS INC3 Filed as: CHOICE BENEFITS, INC. | 715 S. US HIGHWAY 301 TAMPA, FL 33619 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $519 | — | $519 | 18.05% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IA 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $144 | — | $144 | 5.01% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS INC, BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $144 | $144 | 5.01% |
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 | 238 | 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) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 225 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 244 | $95K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 244 | $95K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 244 | $117K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 93 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 94 | $22K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 225 | $1.5M |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 161 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.