| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEVEL 3 INSURANCE ADVISORS, INC.3 Filed as: LEVEL 3 INSURANCE | 201 NORTH NEW YORK AVENUE SUITE 201 WINTER PARK, FL 32789 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $20K | $0 | $20K | 15.00% |
| THE LOOMIS COMPANY5 | 850 NORTH PARK ROAD WYOMISSING, PA 19610 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $16K | $0 | $16K | 12.00% |
| DSM FINANCIAL LLC3 Filed as: DSM FINANCIAL | 950 PENINSULA CORPORATION CIRCLE SUITE 3007 BOCA RATON, FL 33487 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $10K | $0 | $10K | 7.00% |
| LEVEL 3 INSURANCE ADVISORS, INC.3 | 201 NORTH NEW YORK AVENUE SUITE 201 WINTER PARK, FL 32789 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 16.63% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $5K | $5K | 6.51% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFIT ADMIN, INC. | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $934 | $3K | — |
| LEVEL 3 INSURANCE ADVISORS, INC.3 | 201 NORTH NEW YORK AVENUE SUITE 201 WINTER PARK, FL 32789 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $427 | $2K | — |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | — |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ALABAMA | 111 | $700K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 111 | $0 |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 111 | $0 |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 99 | $70K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 99 | $70K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 99 | $70K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ALABAMA | 111 | $700K |
| Other(3 contracts, 3 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 111 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.