| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET SUITE 242 PHOENIX, AZ 85016 | BLUECROSS BLUESHIELD OF ARIZONA | $50K | — | $50K | 4.17% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 7310 NORTH 16TH STREET SUITE 226 PHOENIX, AZ 85020 | BLUECROSS BLUESHIELD OF ARIZONA | $20K | — | $20K | 1.67% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET # 242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.60% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.20% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.81% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.91% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.72% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $980 | $980 | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $962 | $962 | 4.91% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.72% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $942 | $942 | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $925 | $925 | 4.91% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $544 | $544 | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $534 | $534 | 4.91% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $534 | — | $534 | 4.91% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $444 | $444 | 5.00% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $444 | $444 | 5.00% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $419 | $419 | 5.00% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $419 | $419 | 5.00% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 20.01% |
| GIS OF ILLINOIS3 Filed as: GIS BENEFFITS INC | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $293 | $293 | 5.01% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $293 | $293 | 5.01% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $533 | — | $533 | 10.22% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $267 | $267 | 5.12% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $261 | $261 | 5.00% |
| MARK METTILLE3 Filed as: MARK J MATSOCK & ASSOCIATES INC | 5110 NORTH 40TH STREET #242 PHOENIX, AZ 85018 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $509 | — | $509 | 15.03% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $170 | $170 | 5.02% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $170 | $170 | 5.02% |
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 | 136 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ARIZONA | 214 | $1.2M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 84 | $25K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 101 | $11K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 136 | $32K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 39 | $20K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 31 | $19K |
| Prescription drug | BLUECROSS BLUESHIELD OF ARIZONA | 214 | $1.2M |
| Other(6 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 136 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.