| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BNFT ADMNSTRS INC | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $3K | $15K | 18.46% |
| GIS NATIONAL3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.34% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 6.32% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMNSRS INC | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 6.34% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMNSRS INC | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| DIANA LEWIS3 Filed as: DIANA N LEWIS | 28059 US HWY 19 N STE 201 CLEARWATER, FL 33761 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.77% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | COMBINED INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.08% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | COMBINED INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.91% |
| HALVORSON BENEFITS PLUS INC | 3320 WESTRAC DR S FARGO, ND 58103 | TRANSAMERICA LIFE INSURANCE COMPANY | $716 | — | $716 | 3.46% |
| DIANA LEWIS Filed as: DIANA N LEWIS | 28059 US HWY 19 N STE 201 CLEARWATER, FL 33761 | TRANSAMERICA LIFE INSURANCE COMPANY | $76 | — | $76 | 0.37% |
| GIS BENEFITS INC Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | TRANSAMERICA LIFE INSURANCE COMPANY | $13 | — | $13 | 0.06% |
| BENEPORT LLC Filed as: BENEPORT | 28059 US HWY 19 N STE 201 CLEARWATER, FL 33761 | TRANSAMERICA LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 152 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 165 | $80K |
| Life insurance(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 168 | $37K |
| Short-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 165 | $66K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 162 | $28K |
| Other | EQUITABLE | 168 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.