| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 1575 NORTHSIDE DRIVE NW, SUITE 100 ATLANTA, GA 26083 | UNITEDHEALTHCARE INSURANCE COMPANY | $39K | $0 | $39K | 5.26% |
| HOME OFFICE TPA PAYS COMMISSION3 | 475 FALLBROOK BOULEVARD LINCOLN, NE 68521 | AMERITAS LIFE INSURANCE CORPORATION | $6K | $0 | $6K | 6.71% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $2K | $2K | 2.49% |
| USI INSURANCE SERVICES LLC3 | 1575 NORTHSIDE DRIVE NW, SUITE 100 ATLANTA, GA 30318 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $2K | $8K | 20.13% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 6.71% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $983 | $5K | 25.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $266 | $266 | 1.36% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $193 | $193 | 0.98% |
| USI INSURANCE SERVICES LLC3 | 1575 NORTHSIDE DRIVE NW, SUITE 100 ATLANTA, GA 30318 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $60 | $60 | 0.31% |
| USI INSURANCE SERVICES LLC3 | 1575 NORTHSIDE DRIVE NW, SUITE 100 ATLANTA, GA 30318 | COMBINED INSURANCE | $1K | $0 | $1K | 9.65% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | COMBINED INSURANCE | $1K | $0 | $1K | 9.19% |
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 | 78 | 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) | 78 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 180 | $743K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 193 | $83K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 193 | $83K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 141 | $20K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $39K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 104 | $39K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 180 | $743K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 141 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.