| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | — | $13K | $13K | 8.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: HOWALT MCDOWELL INSURANCE | PO BOX 5113 SIOUX FALLS, SD 571175113 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $1K | $7K | 4.53% |
| MARSH & MCLENNAN AGENCY LLC3 | 300 N CHERAPA PLACE 6TH FL SIOUX FALLS, SD 57103 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 13.05% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 5.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 300 N CHERAPA PLACE 6TH FL SIOUX FALLS, SD 57103 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 23.08% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 5.00% |
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 | 369 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 369 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AVERA HEALTH PLANS, INC | 408 | $2.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $155K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 384 | $155K |
| Life insurance | STANDARD INSURANCE COMPANY | 360 | $41K |
| Prescription drug | AVERA HEALTH PLANS, INC | 408 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.