| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOME OFFICE TPA PAYS COMMISSION3 | 5900 O STREET LINCOLN, NE 68510 | AMERITAS LIFE INSURANCE CORPORATION | $14K | $0 | $14K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $3K | $3K | 2.89% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $4K | $19K | 25.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $207 | $207 | 0.27% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $105 | $105 | 0.14% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | UNKNOWN ATLANTA, GA 30327 | COMBINED INSURANCE | $2K | $0 | $2K | 10.11% |
| USI INSURANCE SERVICES LLC3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | COMBINED INSURANCE | $817 | $0 | $817 | 4.65% |
| JOHNSON AND BRYAN INC3 Filed as: JOHNSON AND BRYAN, INC. | UNKNOWN ATLANTA, GA 30327 | COMBINED INSURANCE | $502 | $0 | $502 | 2.85% |
| JOSEPH E. HARRIS3 | UNKNOWN ATLANTA, GA 30327 | COMBINED INSURANCE | $135 | $0 | $135 | 0.77% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | UNKNOWN ATLANTA, GA 30327 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 34.78% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | UNKNOWN ATLANTA, GA 30327 | METLIFE LEGAL PLANS | $367 | $0 | $367 | 8.06% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 4 | $93K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 4 | $93K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 124 | $77K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 124 | $77K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 124 | $77K |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 242 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.