| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | WESTPORT INSURANCE COMPANY | — | $40K | $40K | 15.56% |
| CYPRESS BENEFIT ADMINISTRATORS, LLC3 | 5560 WEST GRANDE MARKET DRIVE APPLETON, WI 54913 | WESTPORT INSURANCE COMPANY | — | $32K | $32K | 12.51% |
| INNOVATIVE BENEFIT PLANNING, LLC3 Filed as: INNOVATIVE CAPTIVE STRATEGIES | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | WESTPORT INSURANCE COMPANY | — | $17K | $17K | 6.67% |
| HEALTHJOY, LLC3 Filed as: HEALTHJOY LLC | P.O. BOX 776932 CHICAGO, IL 606776932 | WESTPORT INSURANCE COMPANY | — | $7K | $7K | 2.89% |
| ZELIS CLAIMS INTEGRITY INC3 Filed as: ZELIS CLAIMS INTEGRITY | 2 CROSSROADS DRIVE BEDMINISTER, NJ 07921 | WESTPORT INSURANCE COMPANY | — | $5K | $5K | 2.04% |
| AMERICAN HEALTH HOLDINGS3 | P.O. BOX 360142 PITTSBURGH, PA 152506142 | WESTPORT INSURANCE COMPANY | — | $2K | $2K | 0.70% |
| HEALTHSMART BENEFIT SOLUTIONS3 Filed as: HEALTHSMART (INTERPLAN HEALTH) | P.O. BOX 207102 DALLAS, TX 753207102 | WESTPORT INSURANCE COMPANY | — | $835 | $835 | 0.33% |
| COFINITY3 | 5231 PAY SPHERE CIRCLE CHICAGO, IL 60674 | WESTPORT INSURANCE COMPANY | — | $439 | $439 | 0.17% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | P.O. BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURACE COMPANY | $11K | $2K | $13K | 20.03% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 604502215 | METROPOLITAN LIFE INSURACE COMPANY | — | $1K | $1K | 2.00% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $887 | $6K | 23.18% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $603 | $5K | 23.02% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $698 | $4K | 18.59% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 3900 EAST CAMELBACK ROAD SUITE 225 PHOENIX, AZ 85018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $772 | $168 | $940 | 18.27% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | 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) | WESTPORT INSURANCE COMPANY | 93 | $254K |
| Dental | METROPOLITAN LIFE INSURACE COMPANY | 179 | $64K |
| Vision | METROPOLITAN LIFE INSURACE COMPANY | 179 | $64K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 57 | $28K |
| Prescription drug | WESTPORT INSURANCE COMPANY | 93 | $254K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.