| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GADA INSURANCE SERVICES3 Filed as: GADA SERVICES | 2060 POWERS FERRY RD SE ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $114K | $114K | 6.55% |
| GADA INSURANCE SERVICES3 Filed as: GADA SERVICES INC | 2060 POWERS FERRY RD. SE ATLANTA, GA 30339 | AMERICAN FIDELITY ASSURANCE COMPANY | $26K | $0 | $26K | 7.99% |
| ASSURANCE AGENCY LTD5 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $19K | $0 | $19K | 5.79% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMIN INC | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $39K | $9K | $48K | 19.90% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH EIN 59-1031071 ADMIN | Claims processing Service code 12 | — | $112K |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 248 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $242K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $242K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 491 | $242K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 186 | $330K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 186 | $330K |
| Other(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 491 | $572K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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.