| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3945 W. ATLANTIC AVENUE DELRAY BEACH, FL 33445 | HEALTH OPTIONS | $21K | — | $21K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3945 W. ATLANTIC AVENUE DELRAY BEACH, FL 33445 | BLUE CROSS BLUE SHIELD OF FLORIDA | $9K | — | $9K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $350 | $3K | 10.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $395 | $2K | 5.95% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 4.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVD - BOCA | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 14.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $685 | — | $685 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $685 | $685 | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SER | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $274 | $274 | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVD - BOCA | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $500 | — | $500 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $500 | $500 | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $200 | $200 | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $668 | $62 | $730 | 10.12% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $334 | $98 | $432 | 5.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | — | $334 | $334 | 4.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $787 | $101 | $888 | 20.45% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $197 | $57 | $254 | 5.85% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, FL 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $197 | $197 | 4.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVD - BOCA | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $388 | — | $388 | 10.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $194 | — | $194 | 5.01% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $194 | $194 | 5.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 SUITE 200W KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 2.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $621 | $94 | $715 | 20.83% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $155 | $45 | $200 | 5.83% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $155 | $155 | 4.52% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $465 | $90 | $555 | 22.58% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $116 | $35 | $151 | 6.14% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $116 | $116 | 4.72% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | HEALTH OPTIONS | 55 | $594K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 109 | $35K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 109 | $28K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $14K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $18K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 17 | $14K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 55 | $589K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.