| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MADDOCK & ASSOCIATES LLC3 Filed as: MADDOCK & ASSOCIATES | 1407 WILLOW RD E SUITE C FIFE, WA 98424 | PREMERA BLUE CROSS | $26K | — | $26K | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFFIT ADMINISTRATOR | 9401 AMBERGLEN BLVD STE 100 AUSTIN, TX 78729 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $4K | $15K | 13.18% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.60% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $684 | $2K | 11.06% |
| MADDOCK & ASSOCIATES LLC3 Filed as: MADDOCK & ASSOCIATES | 1407 WILLOW RD E SUITE C FIFE, WA 98424 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.63% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $236 | $236 | 1.20% |
| MADDOCK & ASSOCIATES LLC3 Filed as: MADDOCK & ASSOCIATES | 1407 WILLOW RD E SUITE C FIFE, WA 98424 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 12.73% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $903 | $379 | $1K | 11.84% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78729 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $127 | $127 | 1.17% |
| MADDOCK & ASSOCIATES LLC3 Filed as: MADDOCK & ASSOCIATES | 1407 WILLOW RD E SUITE C FIFE, WA 98424 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $838 | — | $838 | 21.13% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $495 | $495 | 12.48% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BENEFFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78729 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $46 | $46 | 1.16% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREMERA BLUE CROSS | 111 | $521K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $116K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $116K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 106 | $4K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.