| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R W TROXELL AND COMPANY3 | 214 SOUTH GRAND AVE WEST PO BOX 3757 SPRINGFIELD, IL 62704 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $9K | — | $9K | 1.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BPA TROXELL | 712 IAA DRIVE BLOOMINGTON, IA 61701 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $700 | $700 | 0.11% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $675 | $4K | 23.69% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $589 | $589 | 3.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $275 | $275 | 1.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 4481 ASH GROVE DRIVE STE B SPRINGFIELD, IL 627116359 | METROPOLITAN LIFE INSURANCE COMPANY | — | $75 | $75 | 0.41% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $16 | $16 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON, IA 60006 | COMPANION LIFE | $1K | — | $1K | 12.42% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | COMPANION LIFE | $641 | — | $641 | 6.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $832 | $832 | 11.71% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $409 | $409 | 5.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON, IA 60006 | COMPANION LIFE | $502 | — | $502 | 14.21% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | COMPANION LIFE | $251 | — | $251 | 7.10% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $388 | $388 | 17.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | MONY LIFE INSURANCE COMPANY OF AMERICA | $341 | — | $341 | 15.56% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $2K | $10K | — |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | — | $749 | $749 | — |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4481 ASH GROVE DRIVE STE B SPRINGFIELD, IL 627116359 | METROPOLITAN LIFE INSURANCE COMPANY | — | $64 | $64 | — |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 133 | $660K |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 105 | $18K |
| Vision(2 contracts) | MONY LIFE INSURANCE COMPANY OF AMERICA | 106 | $9K |
| Life insurance(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 106 | $28K |
| Short-term disability(2 contracts) | COMPANION LIFE | 39 | $14K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 105 | $18K |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 105 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.