| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5401 ROGERS AVE STE 202 FORT SMITH, AR 72903 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $33K | $33K | 3.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $3K | $3K | 0.33% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $3K | $15K | 18.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 7.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4 | $4 | 0.01% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 45.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $63 | $3K | 19.80% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $722 | $289 | $1K | 6.47% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMINSTRATORS | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $722 | $722 | 4.62% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 45.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $63 | $3K | 19.76% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $661 | $264 | $925 | 6.44% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $661 | $661 | 4.60% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 45.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 4 ROLLING MEADOWS, IL 600084050 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $63 | $2K | 19.95% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $499 | $200 | $699 | 6.45% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $499 | $499 | 4.61% |
| GIS BENEFITS INC3 Filed as: GIS OF ILLINOIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | METLIFE LEGAL PLANS | $1K | — | $1K | 18.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5401 ROGERS AVE, SUITE 202 FORT SMITH, AR 72903 | METLIFE LEGAL PLANS | $671 | — | $671 | 10.02% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 BLDG I SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $336 | $336 | 5.02% |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 278 | $965K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $79K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $79K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 190 | $76K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 278 | $965K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 476 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.