| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GENERAL INS SERVICES INC3 | PO BOX 70 LA PORTE, IN 463520070 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $1K | $16K | 11.80% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $2K | $9K | 6.48% |
| INNOVATIVE BROKER SOLUTIONS LTD3 | 9405 BORMET DR STE 3 MOKENA, IL 604487400 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $12 | $4K | 2.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995279 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1087 WASSAU, WI 54402 | $176K |
| GENERAL INSURANCE SERVICES, INC. EIN 35-1164638 BROKER | Other commissions Service code 55 | PO BOX 418 MICHIGAN CITY, IN 463610418 | $71K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 599 | $136K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 599 | $136K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 599 | $136K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE | 206 | $668K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 599 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 599 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.