| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | BLUE CROSS BLUE SHIELD OF TEXAS | $45K | $0 | $45K | 4.60% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $2K | $8K | 11.06% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 5.73% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAMPMAN BENEFIT | ADMINISTRATORS PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.98% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 20.88% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $914 | $2K | 9.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $659 | $3K | 21.52% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $659 | $527 | $1K | 9.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $476 | $158 | $634 | 13.40% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $236 | $0 | $236 | 4.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $234 | $0 | $234 | 4.95% |
| GIS BENEFITS INC3 | 9500 KOGER AVE STE 200 ST PETERSBURG, FL 33702 | METROPOLITAN LIFE INSURANCE COMPANY | $709 | $0 | $709 | 21.90% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 SUITE 100 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $164 | $164 | 5.07% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | SAFEGUARD HEALTH PLANS, INC. | $291 | $36 | $327 | 11.25% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC. | $145 | $58 | $203 | 6.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAMPMAN BENEFIT | ADMINISTRATORS PO BOX 9201 AUSTIN, TX 78766 | SAFEGUARD HEALTH PLANS, INC. | $0 | $87 | $87 | 2.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $142 | $114 | $256 | 9.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $142 | $142 | 4.99% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $256 | $85 | $341 | 13.41% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $127 | $0 | $127 | 4.99% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $126 | $0 | $126 | 4.95% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS | 150 | $976K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $79K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $76K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $99K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 30 | $13K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $3K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS | 150 | $976K |
| Other(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 170 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.