| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | SWISS RE-SWISS RE | $0 | $0 | $0 | 0.00% |
| MJ INSURANCE3 Filed as: MJ INS INC | PO BOX 3430 CARMEL, IN 46082 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $4K | $23K | 16.50% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $3K | $11K | 8.05% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10K | $10K | 6.73% |
| BUKATY COMPANIES3 | 4601 COLLEGE BLVD SUITE 100 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $15 | $8K | 5.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 MEDICAL PLAN TPA | Contract Administrator; Claims processing Service code 12 | — | $174K |
| MJ INSURANCE AGENT/BROKER | Insurance agents and brokers Service code 22 | PO BOX 3430 CARMEL, IN 46082 | $11K |
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 | 432 | 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) | 432 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SWISS RE-SWISS RE | 234 | $375K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $141K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $141K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $141K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $141K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 432 | $141K |
| Prescription drug | SWISS RE-SWISS RE | 234 | $375K |
| Stop-loss / reinsurancereinsurance | SWISS RE-SWISS RE | 234 | $375K |
| Other(2 contracts, 2 carriers) | SWISS RE-SWISS RE | 432 | $516K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 432 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.