| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE MORRIS, IL 60450 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.75% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $965 | $965 | 5.60% |
| ASSUREDPARTNERS3 | 8101 NORTH HIGH STREET, SUITE 30 COLUMBUS, OH 43235 | STARMOUNT LIFE INSURANCE COMPANY | $494 | $0 | $494 | 2.87% |
| ASSUREDPARTNERS3 | 8101 NORTH HIGH STREET, SUITE 30 COLUMBUS, OH 43235 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 13.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $976 | $976 | 6.57% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $742 | $742 | 5.00% |
| ASSUREDPARTNERS3 | 27064 OAKMEAD DRIVE PERRYSBURG, OH 43551 | UNUM INSURANCE COMPANY | $441 | $0 | $441 | 12.55% |
| ASSUREDPARTNERS3 | 8101 NORTH HIGH STREET, SUITE 30 COLUMBUS, OH 43235 | UNUM INSURANCE COMPANY | $317 | $0 | $317 | 9.02% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE MORRIS, IL 60450 | UNUM INSURANCE COMPANY | $110 | $43 | $153 | 4.36% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM INSURANCE COMPANY | $143 | $0 | $143 | 4.07% |
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 | 105 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 57 | $17K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 57 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 105 | $15K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 105 | $15K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 105 | $15K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 105 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.