| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 721 EMERSON ROAD, SUITE 400 SAINT LOUIS, MO 63141 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $79K | $0 | $79K | 1.73% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 721 EMERSON ROAD, SUITE 400 SAINT LOUIS, MO 63141 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $0 | $13K | 10.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| CLEARVIEW NATIONAL PARTNERS, LLC3 | 318 BEAR HILL ROAD, SUITE 1 WALTHAM, MA 02451 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $159 | $0 | $159 | 10.01% |
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 | 226 | 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) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 490 | $4.6M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 490 | $4.6M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $127K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $127K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 490 | $4.6M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.