| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | KAISER FOUNDATION HEALTH PLAN, INC. | $77K | $0 | $77K | 5.20% |
| MJ INSURANCE3 | 571 MONON TRAIL CARMEL, IN 46032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | $0 | $16K | 11.10% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $9K | $12K | 8.31% |
| MJ INSURANCE3 | 2730 EAST CAMELBACK ROAD, SUITE 250 PHOENIX, AZ 85016 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.03% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT. ADMNSTRTS., INC. | PO BOX 9039 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.72% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORPORATION | $563 | $706 | $1K | 5.43% |
| HOME OFFICE TPA PAYS COMMISSION3 | 5900 O STREET LINCOLN, NE 68510 | AMERITAS LIFE INSURANCE CORPORATION | $772 | $0 | $772 | 3.30% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | BLUE CROSS OF CALIFORNIA | $4K | $0 | $4K | 28.07% |
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 | 694 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 186 | $1.5M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 220 | $147K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 455 | $23K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 694 | $162K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 220 | $147K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 186 | $1.5M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 694 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 694 | — |
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.