| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA INC | $72K | — | $72K | 3.76% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE CO | $76K | $26K | $102K | 22.93% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $7K | $3K | $10K | 2.28% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE CO | — | $4K | $4K | 0.81% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | COMPANION LIFE INSURANCE CO | $4K | — | $4K | 9.99% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $1K | $75 | $1K | 19.26% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE CO | $316 | $126 | $442 | 6.35% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADM. | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE CO | — | $316 | $316 | 4.54% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $811 | $58 | $869 | 19.38% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE CO | $203 | $81 | $284 | 6.33% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADM. | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE CO | — | $203 | $203 | 4.53% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD HEALTHCARE OF GEORGIA INC | 339 | $1.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE CO | 435 | $484K |
| Vision(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE CO | 435 | $484K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE CO | 435 | $484K |
| Short-term disability | METROPOLITAN LIFE INSURANCE CO | 435 | $444K |
| Long-term disability | METROPOLITAN LIFE INSURANCE CO | 435 | $444K |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE CO | 435 | $455K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 435 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.