| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 6050 OAK TREE BLVD INDEPENDENCE, OH 44131 | HUMANA INSURANCE COMPANY | $2K | $46 | $2K | 6.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BNFTS & INS SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 7.70% |
| MODEL CONSULTING INC3 | 3160 TREMONT AVE TREVOSE, PA 19053 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $445 | — | $445 | 2.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BNFTS & INS SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 8.08% |
| MODEL CONSULTING INC3 | 3160 TREMONT AVE TREVOSE, PA 19053 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $409 | — | $409 | 2.87% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BNFTS & INS SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 11.37% |
| MODEL CONSULTING INC3 | 3160 TREMONT AVE TREVOSE, PA 19053 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $492 | — | $492 | 3.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BNFTS & INS SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 11.25% |
| MODEL CONSULTING INC3 | 3160 TREMONT AVE TREVOSE, PA 19053 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $501 | — | $501 | 3.75% |
| MODEL CONSULTING INC3 Filed as: MODEL CONSULTANTS, INC | 3160 TREMONT AVE TREVOSE, PA 19053 | AMERICAN HERITAGE LIFE | $2K | — | $2K | 15.47% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS | 199 SCOTT ST 8TH FLOOR BUFFALO, NY 14204 | AMERICAN HERITAGE LIFE | $1K | — | $1K | 11.30% |
| MODEL CONSULTING INC3 | 3160 TREMONT AVE TREVOSE, PA 190536644 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 9.85% |
| LIAZON BENEFITS INC5 | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | — | $517 | $517 | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 951 YAMATO RD SUITE 200W BOCA RATON, FL 33431 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $677 | — | $677 | 7.53% |
| LIAZON BENEFITS INC3 | 737 MAIN ST STE 200 BUFFALO, NY 14203 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $464 | — | $464 | 5.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 3160 TREMONT AVE TREVOSE, PA 19053 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $222 | — | $222 | 2.47% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, LLC | 1767 SENTRY PKWY WEST BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9 | — | $9 | 0.10% |
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 | 212 | 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) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 215 | $1.0M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 81 | $49K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 61 | $9K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $28K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $18K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $14K |
| Other(3 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.