| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $240 | $41 | $281 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $183 | $183 | 0.02% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | METROPOLITAN LIFE INSURANCE COMPANY | -$2K | $2K | $0 | 0.00% |
| EPSI BENEFITS, INC.3 | 2180 NORTH LOOP WEST, SUITE 400 HOUSTON, TX 77018 | METROPOLITAN LIFE INSURANCE COMPANY | -$22K | — | -$22K | -2.91% |
| PATRICIA A. BOLLI4 | 5902 EVENING SUN COURT RICHMOND, TX 77469 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $11K | — | $11K | 20.15% |
| DEANNE LYLES4 | 3522 CYPRESS LANDING COURT ROSENBERG, TX 77471 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $5K | — | $5K | 10.12% |
| LARRY COLE4 | 269 ROYAL TROON DRIVE CIBOLO, TX 78108 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $355 | — | $355 | 0.66% |
| W. WILLIAM WORNARDT III4 Filed as: W. WILLIAM WORNARDT | 7707 TIBURON TRAIL SUGAR LAND, TX 77479 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $93 | — | $93 | 0.17% |
| MJ INSURANCE4 Filed as: JOHN H. GIVENS AND VARIOUS AGENTS | 1 LINDQUIST SAN ANTONIO, TX 78248 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $51 | — | $51 | 0.10% |
| LYNNE MULCAHY4 | 4802 SCHILLER PARK LANE SUGAR LAND, TX 77479 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $37 | — | $37 | 0.07% |
| CROWN RISK MANAGEMENT, LLC4 Filed as: HARVARD RISK MANAGEMENT, LLC | 8275 VINCENT ROAD, SUITE 202 DENHAM SPRINGS, LA 70726 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $36 | — | $36 | 0.07% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | — | $51 | $51 | 0.15% |
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 | 1,924 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,941 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,524 | $790K |
| Vision | EYEMED VISION CARE | 1,704 | $94K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,524 | $756K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,524 | $756K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,524 | $756K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,524 | $809K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,524 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.