| 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 | $7K | $5K | $12K | 1.34% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 SOUTH GARLAND AVENUE. SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $54 | $54 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS AND WILLIAMS, INC. | 818 TOWN AND COUNTRY BOULEVARD SUITE 500 HOUSTON, TX 77024 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $31 | $31 | 0.00% |
| DEANNE LYLES4 | 11230 CEDAR DRIVE MABANK, TX 75156 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $4K | $0 | $4K | 4.80% |
| W. WILLIAM WORNARDT III4 Filed as: WILLIAM W. WORNARDT III | 7707 TIBURON TRAIL SUGAR LAND, TX 77479 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $4K | $0 | $4K | 4.80% |
| PATRICIA A. BOLLI4 | PO BOX 603 BURWELL, NE 68823 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 2.47% |
| DON R. WILSON4 | 146 RAINBOW DRIVE LIVINGSTON, TX 77399 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 1.52% |
| L-K MARKETING GROUP, LLC4 | PO BOX 8072 WACO, TX 76714 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 1.16% |
| PROPER CARE4 | 10229 SOUTH RIVER TRAIL KNOXVILLE, TN 37922 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $859 | $0 | $859 | 0.94% |
| EDWARD G. BURFORD4 Filed as: EDWARD G. BURFORD AND OTHER AGENTS | 5719 CLUB HILL CIRCLE DALLAS, TX 75248 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $135 | $0 | $135 | 0.15% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $72 | $75 | $147 | 1.05% |
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 | 2,370 | 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) | 2,370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,276 | $884K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 2,204 | $150K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,370 | $1.3M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,370 | $1.3M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,370 | $1.3M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,370 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,370 | — |
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.