| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 31420 INDEPENDENCE, OH 44131 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 3.40% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 11.12% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 6.32% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNEWR INS CENTER | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.45% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVS | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 12.14% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 6.81% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.78% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 11.12% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 6.29% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.45% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 7.37% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 5.66% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.34% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST STE 675 SAN JOSE, CA 95113 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 11.88% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 6.86% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFITS ADMINISTRATOR | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 Filed as: EDGEWOOD PARTNERS INS CENTER | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 4.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 13.39% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 6.61% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $880 | — | $880 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $69 | $69 | 0.39% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 13.42% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BOULEVARD SUITE 200 DULUTH, GA 30096 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $568 | — | $568 | 6.59% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $431 | — | $431 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN B | 9401 AMBERGLEN BLVD SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $34 | $34 | 0.39% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $697 | — | $697 | 9.01% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BLVD STE 200 DULUTH, GA 30096 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $464 | — | $464 | 5.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | 9401 AMBERGLEN BLVD BLDG. 1 SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $387 | — | $387 | 5.00% |
| MARK METTILLE3 Filed as: MARK METTILLE C/O GROUP INSURANCE S | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $387 | — | $387 | 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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 122 | $660K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $47K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 122 | $660K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $93K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $48K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $81K |
| Other(5 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.