| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | AETNA HEALTH, INC. | $36K | $3K | $38K | 5.69% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE COMPANY | $17K | $2K | $19K | 6.16% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $3K | $13K | 13.14% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 9500 KOGER AVE. ST. PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $387 | — | $387 | 6.78% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL STREET, SUITE 110 NEWPORT BEACH, CA 92660 | METLIFE LEGAL PLANS | $230 | — | $230 | 4.03% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | P.O. BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $166 | $166 | 2.91% |
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 | 198 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 169 | $981K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 198 | $98K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 198 | $98K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 198 | $98K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 169 | $981K |
| Other | METLIFE LEGAL PLANS | 17 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.