| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 8.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $2K | $10K | 10.42% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $6K | 6.38% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $1K | $11K | 17.29% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $807 | $4K | 6.31% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $729 | $6K | 22.76% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $417 | $2K | 6.58% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $492 | $6K | 27.44% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $281 | $1K | 6.39% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $510 | $4K | 22.61% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $989 | $291 | $1K | 6.48% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MARK METTILLE3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $732 | — | $732 | 5.00% |
| JACOB O'KEEFE3 | 2405 SCHOFIELD AVENUE STE. 240 WESTON, WI 54476 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $699 | $157 | $856 | 12.24% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $350 | $90 | $440 | 6.29% |
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 | 254 | 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) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 532 | $102K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 532 | $102K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $62K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 119 | $92K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 105 | $20K |
| Other(5 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 532 | — |
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.