| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3945 W. ATLANTIC AVENUE DELRAY BEACH, FL 33445 | HEALTH OPTIONS | $24K | — | $24K | 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 | $4K | $766 | $5K | 11.92% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $327 | $2K | 5.81% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6 | $6 | 0.02% |
| 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 | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $616 | — | $616 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $616 | $616 | 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 | — | $246 | $246 | 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 | $2K | — | $2K | 16.50% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $545 | — | $545 | 5.50% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $545 | $545 | 5.50% |
| 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 | — | $218 | $218 | 2.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $627 | $189 | $816 | 13.30% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $313 | $81 | $394 | 6.42% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | — | $313 | $313 | 5.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $945 | $125 | $1K | 22.08% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $236 | $56 | $292 | 6.03% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $214 | $214 | 4.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVD - BOCA | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $446 | — | $446 | 10.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $223 | — | $223 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $223 | $223 | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 SUITE 200W KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $89 | $89 | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $847 | $153 | $1K | 22.76% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $212 | $53 | $265 | 6.03% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, FL 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $192 | $192 | 4.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $335 | $95 | $430 | 13.81% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $84 | $22 | $106 | 3.40% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $81 | $81 | 2.60% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | HEALTH OPTIONS | 63 | $656K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $44K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $38K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $17K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 17 | $10K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 17 | $10K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 63 | $648K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.