| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $82K | — | $82K | 12.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | DELTA DENTAL OF ARIZONA | $13K | — | $13K | 4.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | DELTA DENTAL OF ARIZONA | $8K | — | $8K | 4.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $5K | — | $5K | 4.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | AMERICAN HERITAGE LIFE INSURANCE | $26K | — | $26K | 24.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AMERICAN HERITAGE LIFE INSURANCE | $1K | — | $1K | 1.34% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | ALPHA DENTAL OF ARIZONA, INC. | $1K | — | $1K | 4.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | HYATT LEGAL PLANS | $3K | $329 | $3K | 8.90% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | AMERICAN HERITAGE LIFE INSURANCE | $6K | — | $6K | 20.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $744K |
| CBIZ BENEFITS & INS SERVICE INC. EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $0 |
| COMPSYCH EIN 35-3739783 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $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 | 1,061 | 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) | 1,061 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF ARIZONA | 365 | $572K |
| Vision | VISION SERVICE PLAN | 698 | $117K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,061 | $663K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,061 | $663K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,061 | $663K |
| Other(4 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,061 | $832K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,061 | — |
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.