| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONOVER INSURANCE SERVICES LLC3 Filed as: CONOVER INSURANCE SERVICES, LLC | 3911 CASTLEVALE RD STE 201 YAKIMA, WA 98902 | HCC LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 6.68% |
| CONOVER INSURANCE SERVICES LLC3 | 3911 CATLEVALE RD STE 201 YAKIMA, WA 98902 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $1K | $3K | 3.50% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 2.05% |
| CONOVER INSURANCE SERVICES LLC3 | 3911 CASTLEVALE RD STE 201 YAKIMA, WA 98902 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 16.58% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 7.26% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 3.29% |
| CONOVER INSURANCE SERVICES LLC3 | 3911 CASTLEVALE RD STE 201 YAKIMA, WA 98902 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 17.04% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 7.60% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $582 | $582 | 3.29% |
| CONOVER INSURANCE SERVICES LLC3 Filed as: CONOVER INSURANCE SERVICES, LLC | PO BOX 10088 YAKIMA, WA 98909 | VISION SERVICE PLAN | $566 | — | $566 | 3.79% |
| CONOVER INSURANCE SERVICES LLC3 | 3911 CASTLEVALE RD STE 201 YAKIMA, WA 98902 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 16.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $708 | $708 | 7.41% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $314 | $314 | 3.28% |
| AXIS INSURANCE LLC | 155 108TH AVE NE STE 725 BELLEVUE, WA 980099007 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $668 | — | $668 | 17.05% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $351 | $351 | 8.96% |
| BOON CHAPMAN BNFT ADMNSTRS INC3 | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $129 | $129 | 3.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTEED PLANS SERVICE CORPORATION EIN 91-0780588 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $52K |
| CONOVER BENEFITS EIN 91-1020209 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $40K |
| FIRST CHOICE EIN 91-1272766 PREFERRED PROVIDER ORG | Other services Service code 49 | — | $7K |
| FIRST HEALTH EIN 20-1736437 PREFERRED PROVIDER ORG. | Other services Service code 49 | — | $3K |
| AMERICAN HEALTH HOLDING EIN 31-1367946 UTILIZATION REVIEW SERV. | Other services Service code 49 | — | $3K |
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 | 185 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 175 | $284K |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $95K |
| Vision | VISION SERVICE PLAN | 176 | $15K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $65K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 110 | $18K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 175 | $284K |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.