| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROVIDENCE BENEFITS SOLUTIONS LLC3 | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 7.97% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFITS SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $948 | — | $948 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $177 | $177 | 0.93% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFITS SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $592 | — | $592 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $118 | $118 | 1.00% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFITS SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $456 | — | $456 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $55 | $55 | 0.60% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFITS SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $375 | — | $375 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $54 | $54 | 0.72% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 W CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD | $828 | — | $828 | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | $276 | — | $276 | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | — | $37 | $37 | 0.67% |
| PROVIDENCE BENEFITS SOLUTIONS LLC3 Filed as: PROVIDENCE BENEFIT SOLUTIONS, LLC | 3401 WEST CYPRESS STREET SUITE 203 TAMPA, FL 33607 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $529 | — | $529 | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $176 | — | $176 | 4.99% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $34 | $34 | 0.96% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 91 | $41K |
| Vision | HUMANA INSURANCE COMPANY | 91 | $41K |
| Life insurance(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 91 | $69K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 50 | $12K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 57 | $19K |
| Other(6 contracts, 3 carriers) | HUMANA INSURANCE COMPANY | 91 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 91 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.