| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | $26K | — | $26K | 4.98% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 2421 ATLANTIC AVE MANASQUAN, NJ 08736 | FIRST UNUM LIFE INSURANCE COMPANY | $24K | — | $24K | 4.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | FIRST UNUM LIFE INSURANCE COMPANY | — | $10K | $10K | 2.15% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 2421 ATLANTIC AVE MANASQUAN, NJ 08736 | FIRST UNUM LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | FIRST UNUM LIFE INSURANCE COMPANY | — | $2K | $2K | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $2K | — | $2K | 2.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $926 | $497 | $1K | 7.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $652 | $360 | $1K | 7.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 2421 ATLANTIC AVE MANASQUAN, NJ 08736 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 2421 ATLANTIC AVE MANASQUAN, NJ 08736 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $633 | — | $633 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $127 | $127 | 2.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATOR | Participant communication; Contract Administrator; Direct payment from the plan; Other services; Float revenue; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $598K |
| CBIZ BENEFITS & INSURANCE SRVC(OH) BROKER | Insurance agents and brokers Service code 22 | PO BOX 632886 CINCINNATI, OH 45263 | $112K |
| TELUS HEALTH (US) LTD EIN 52-1883918 EMPLOYEE ASSISTANCE PLAN | Contract Administrator Service code 13 | — | $12K |
| CIGNA | Other services; Float revenue; Contract Administrator; Direct payment from the plan; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication Service code 12 | — | $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 | 530 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 540 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 846 | $516K |
| Vision | VISION SERVICE PLAN | 475 | $72K |
| Life insurance(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 530 | $566K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 530 | $486K |
| Long-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 530 | $490K |
| Other(6 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 530 | $613K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 846 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.