| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | 2290 LUCIEN WAY STE 205 MAITLAND, FL 32751 | ANTHEM LIFE AND DISABILITY INS CO | $16K | — | $16K | 9.56% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | ANTHEM BLUE CROSS | $5K | — | $5K | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS EIN 23-7391136 CLAIMS ADMINISTRATOR | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Other services Service code 12 | — | $608K |
| PRIME THERAPEUTICS MANAGEMENT, LLC EIN 46-3708039 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Other fees Service code 12 | — | $16K |
| CBIZ BENEFITS & INSURANCE SERVICESI BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $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 | 505 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 508 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF NEW YORK | 865 | $338K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK | 1,034 | $105K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE AND DISABILITY INS CO | 775 | $219K |
| Short-term disability(2 contracts, 2 carriers) | ANTHEM LIFE AND DISABILITY INS CO | 775 | $219K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM LIFE AND DISABILITY INS CO | 775 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,034 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.