| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $39K | $0 | $39K | 8.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 6650 METAIRIE, LA 70009 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 17.67% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 BLDG 1 SUITE 100 AUSTIN, TN 78766 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 4.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | GIS BENEFITS INC MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2487 CEDARCREST ROAD SUITE 122 ACWORTH, GA 30101 | COMBINED INSURANCE | $2K | $0 | $2K | 9.91% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | COMBINED INSURANCE | $2K | $0 | $2K | 9.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CARRIER | Contract Administrator; Claims processing; Non-monetary compensation; Participant communication; Other services; Named fiduciary; Direct payment from the plan; Float revenue Service code 12 | — | $27K |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 111 | $468K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 111 | $468K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 157 | $83K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 157 | $83K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 157 | $83K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 157 | $83K |
| Other(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 157 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.