| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45236 | AETNA LIFE INSURANCE CO. | — | $12K | $12K | 0.40% |
| HARRIS A KIVITZ3 | 253 STONEWAY LANE MERIOR STATION, PA 19066 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 13.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45236 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45236 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.95% |
| HARRIS A KIVITZ3 | 253 STONEWAY LANE MERIOR STATION, PA 19066 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 13.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $281 | $281 | 1.89% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 329 | $3.0M |
| Dental | AETNA LIFE INSURANCE CO. | 329 | $3.0M |
| Vision | AETNA LIFE INSURANCE CO. | 329 | $3.0M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 225 | $96K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 187 | $93K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 225 | $119K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 225 | $417K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 329 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.