| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $21K | $21K | 4.23% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE SERVICES LL | 2270 DOUGLAS BLVD., STE 220 ROSEVILLE, CA 95661 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $4K | $4K | 0.75% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $4K | $21K | 19.56% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 282896620 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.65% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.42% |
| BOONE-CHAPMAN BENEFIT ADMINISTRATOR3 | PO BOX 9201 BLDG 1 SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL | $164 | $92 | $256 | 8.17% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVE STE 200 ST PETERSBURG, FL 33702 | METLIFE LEGAL | $198 | — | $198 | 6.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES (CA) | 3111 CAMINO DEL RIO N SUITE 1100 SAN DIEGO, CA 92108 | METLIFE LEGAL | $148 | — | $148 | 4.72% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | METLIFE LEGAL | $16 | — | $16 | 0.51% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 63 | $640K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $109K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $109K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $109K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $109K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $109K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 160 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.