| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 1765 E SKYLINE DRIVE TUCSON, AZ 85718 | DELTA DENTAL OF TENNESSEE | $44K | — | $44K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $26K | $3K | $29K | 16.73% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $19K | $2K | $21K | 16.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | $1K | $14K | 16.71% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $18K | — | $18K | 27.82% |
| IMA, INC.3 Filed as: IMA INC | PO BOX 2992 WICHITA, KS 67201 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $35 | $314 | $349 | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $136 | $209 | $345 | 0.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $747 | $3K | 8.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 452632886 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 36.86% |
| IMA, INC.3 Filed as: IMA INC | PO BOX 2992 WICHITA, KS 67201 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $48 | $277 | $325 | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE IN | 2000 MORRIS AVE SUITE 1400 BIRMINGHAM, AL 35203 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $190 | $103 | $293 | 0.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $567K |
| CBIZ BENEFITS & INS SERVICES INC EIN 31-1582098 BROKER | Other commissions Service code 55 | — | $87K |
| EMPLOYEE RESOURCE SYSTEMS, INC. EIN 36-3867645 EAP PROVIDER | Other services Service code 49 | — | $71K |
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 | 1,286 | 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) | 1,286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 1,165 | $82K |
| Dental | DELTA DENTAL OF TENNESSEE | 1,219 | $440K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 1,165 | $82K |
| Life insurance(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,286 | $126K |
| Short-term disability(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 400 | $236K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 248 | $128K |
| Other(3 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,286 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,286 | — |
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.