| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WGB BENEFITS INSURANCE SERVICES3 | 15901 REDHILL AVENUE, SUITE 100 TUSTIN, CA 92780 | HEALTH NET | $48K | — | $48K | 7.49% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $1K | $11K | 11.30% |
| GIS OF ILLINOIS3 Filed as: GIS BENEITS INC | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 6.40% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CNAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 4.57% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC | $749 | — | $749 | 8.36% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC | $412 | $165 | $577 | 6.44% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CNAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | SAFEGUARD HEALTH PLANS, INC | — | $412 | $412 | 4.60% |
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 | 145 | 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. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 68 | $646K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $107K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $98K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $98K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $98K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $98K |
| Prescription drug | HEALTH NET | 68 | $646K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 174 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.