| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. CO. | PO BOX 632886 CINCINNATI, OH 45623 | AETNA | $2K | $0 | $2K | 6.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINATTI, OH 45263 | MONY LIFE INSURANCE COMPANY OF AMERICA | $567 | $0 | $567 | 6.15% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. | PO BOX 632886 CINCINNATI, OH 452632866 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $615 | $0 | $615 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $41K |
| CBIZ BENEFITS & INS SERVICES BROKER | Insurance agents and brokers Service code 22 | 401 PLYMOUTH RD PLYMOUTH MEETING, PA 19462 | $24K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $17K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $5K |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA | 86 | $32K |
| Life insurance(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 164 | $13K |
| Long-term disability(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 164 | $13K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 93 | $189K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 106 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.