| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 8.33% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 5.83% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.50% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN | 250 PEHLE AVE, STE 400 PARK 80 PLAZA 2 SADDLE BROOK, NJ 07663 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $583 | $583 | 0.83% |
| MARSH & MCLENNAN AGENCY LLC3 | 6279 TRI RIDGE BLVD, STE 400 LOVELAND, OH 45140 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4 | $4 | 0.01% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $2K | $8K | 18.39% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $149 | $2K | 5.33% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS, INC | 9401 AMBERGLEN BLVD, STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $174 | $174 | 0.38% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $633 | $3K | 18.44% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $920 | $57 | $977 | 5.31% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS, INC | 9401 AMBERGLEN BLVD, STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $74 | $74 | 0.40% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $643 | $3K | 18.59% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $895 | $314 | $1K | 6.75% |
| ADMINISTRATORS, INC, BOON-CHAPMAN B3 Filed as: ADMINISTRATORS, INC. | 9401 AMBERGLEN BLVD, STE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $76 | $76 | 0.42% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $76 | $406 | $482 | 63.84% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $38 | $34 | $72 | 9.54% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $53 | $211 | $264 | 49.81% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $27 | $23 | $50 | 9.43% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE, MMA | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $36 | $176 | $212 | 59.38% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $18 | $16 | $34 | 9.52% |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 148 | $749K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 163 | $70K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 154 | $7K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 152 | $18K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 38 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 152 | $46K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 152 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.