| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC(OH) | P. O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $61K | $61K | 5.39% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC | 225 WIRELESS BLVD SUITE 200 HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $31K | $31K | 2.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 9.76% |
| PROFESSIONAL GROUP PLAN INC3 Filed as: PROFESSIONAL GROUP PLAN | 225 WIRELESS BLVD SUITE 200 HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $5K | $5K | 4.88% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $11K | — | $11K | 15.65% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | $7K | $8K | 12.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $6K | — | $6K | 15.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $811 | $4K | $5K | 11.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 15.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $93 | $955 | $1K | 12.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $811 | — | $811 | 15.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NC 11788 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | -$8 | $653 | $645 | 11.93% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | -$184 | $390 | $206 | — |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | -$64 | — | -$64 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATION FEES | Contract Administrator Service code 13 | — | $57K |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 107 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 93 | $96K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 93 | $96K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 192 | $8K |
| Short-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 140 | $42K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 140 | $5K |
| Other(3 contracts) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 192 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.