| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | 9401 AMBERGLEN BLVD STE 100 AUSTIN, TX 78729 | METROPOLITAN LIFE INSURANCE CO | $15K | $3K | $18K | 23.82% |
| EMPLOYERS PLAN SERVICES INC5 | 2180 N LOOP W STE 400 HOUSTON, TX 77018 | METROPOLITAN LIFE INSURANCE CO | $9K | $1K | $10K | 13.45% |
| MARK METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE CO | — | $3K | $3K | 3.65% |
| JAMES PERRY ZANDER3 | 4655 NORTH CENTRAL EXPWY DALLAS, TX 75205 | METROPOLITAN LIFE INSURANCE CO | $69 | — | $69 | 0.09% |
| MARK METTILLE3 | 2180 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS | — | $279 | $279 | 3.58% |
| JAMES PERRY ZANDER3 | 4655 NORTH CENTRAL EXPWY DALLAS, TX 75205 | SAFEGUARD HEALTH PLANS | $56 | — | $56 | 0.72% |
| MONTGOMERY MANAGEMENT0 | 3581 ATLANTA AVE HAPEVILLE, GA 30354 | MONTGOMERY MANAGEMENT | $467K | — | $467K | — |
| ASSURED BENEFITS ADMINISTRATORS5 Filed as: ASSURED BENEFITS ADMINISTRATION | 4855 N MESA SUITE 130 EL PASO, TX 79912 | MONTGOMERY MANAGEMENT | $113K | — | $113K | — |
| JAMES PERRY ZANDER3 | 4655 NORTH CENTRAL EXPWY DALLAS, TX 75205 | MONTGOMERY MANAGEMENT | $49K | — | $49K | — |
| CWI BENEFITS, INC.0 Filed as: CWI BENEFITS | PO BOX 6125 GREENVILLE, SC 29606 | MONTGOMERY MANAGEMENT | $29K | — | $29K | — |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MONTGOMERY MANAGEMENT | 139 | $0 |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE CO | 179 | $84K |
| Vision | METROPOLITAN LIFE INSURANCE CO | 179 | $76K |
| Life insurance | METROPOLITAN LIFE INSURANCE CO | 179 | $76K |
| Short-term disability | METROPOLITAN LIFE INSURANCE CO | 179 | $76K |
| Long-term disability | METROPOLITAN LIFE INSURANCE CO | 179 | $76K |
| Other | METROPOLITAN LIFE INSURANCE CO | 179 | $76K |
| 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."
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.