| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | UNITED HEALTHCARE INSURANCE COMPANY | $800 | $42K | $43K | 5.46% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 10.00% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 8.00% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $0 | $5K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $349 | $2K | 6.05% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $774 | $774 | 2.33% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $321 | $2K | 6.09% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $704 | $704 | 2.39% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $285 | $2K | 6.13% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $591 | $591 | 2.34% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $515 | $81 | $596 | 5.79% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $231 | $231 | 2.24% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $757 | $0 | $757 | 15.00% |
| GIS BENEFITS INC5 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $252 | $54 | $306 | 6.06% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $116 | $116 | 2.30% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $625 | $0 | $625 | 15.18% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $208 | $46 | $254 | 6.17% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $99 | $99 | 2.41% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 76101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $271 | $0 | $271 | 15.01% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $90 | $18 | $108 | 5.98% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BLVD BLDG 1 STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $42 | $42 | 2.33% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 191 | $790K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 86 | $52K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 191 | $790K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 86 | $34K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 70 | $25K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 199 | $33K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 86 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.