| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TONY REA3 | 2 CENTERPOINT DRIVE SUITE 515 LAKE OSWEGO, OR 97035 | CIGNA LIFE INSURANCE COMPANY | $41K | — | $41K | 13.03% |
| TONY REA3 | 2 CENTERPOINT DRIVE SUITE 515 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | — | $13K | 14.54% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $234 | $5K | 5.11% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFI ADMINISTATORS | P.O. BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 4.85% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.49% |
| DESSO FORMAN3 | 28059 US HIGHWAY 19 N SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $783 | — | $783 | 7.31% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $518 | $29 | $547 | 5.11% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | P.O. BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $518 | $518 | 4.84% |
| TONY REA3 | 2 CENTERPOINT DRIVE SUITE 515 LAKE OSWEGO, OR 97035 | METROPOLITAN LIFE INSURANCE COMPANY | $336 | — | $336 | 3.14% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $161 | $161 | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA | Participant communication; Named fiduciary; Direct payment from the plan; Other services; Non-monetary compensation; Float revenue; Claims processing; Contract Administrator Service code 12 | — | $0 |
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 | 353 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY | 275 | $326K |
| Vision | CIGNA LIFE INSURANCE COMPANY | 275 | $315K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 492 | $89K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 492 | $89K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 492 | $89K |
| Prescription drug | CIGNA LIFE INSURANCE COMPANY | 275 | $315K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 492 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 492 | — |
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.