| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 152125860 | UNITEDHEALTHCARE INSURANCE COMPANY | $32K | — | $32K | 4.23% |
| SEUBERT & ASSOCIATES, INC.3 | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 152125860 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 10.44% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 604502215 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $3K | $6K | 8.13% |
| DIANA LEWIS3 Filed as: DIANA N LEWIS | 28059 US HIGHWAY 19 NORTH SUITE 201 CLEARWATER, FL 33761 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $509 | — | $509 | 6.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $424 | — | $424 | 5.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $339 | $66 | $405 | 4.78% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $190 | $190 | 2.24% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN B ADMINISTRATORS, INC. | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| DIANA LEWIS3 Filed as: DIANA N LEWIS | 28059 US HIGHWAY 19 NORTH SUITE 201 CLEARWATER, FL 33761 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $378 | — | $378 | 6.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $315 | — | $315 | 5.01% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE PITTSBURGH, PA 15212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $252 | $51 | $303 | 4.81% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $141 | $141 | 2.24% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN B ADMINISTRATORS, INC. | 9401 AMBERGLEN BOULEVARD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 141 | $757K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $78K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $78K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $78K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $78K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 159 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.