| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY BENEFIT ADMINISTRATORS, INC3 Filed as: KEY BENEFIT ADMINISTRATORS, INC. | 8330 ALLISON POINTE TRAIL INDIANAPOLIS, IN 46250 | UNITED STATES FIRE INSURANCE COMPANY | $29K | $0 | $29K | 10.71% |
| PROACTIVE RISK SOLUTION3 | 3880 PARKWOOD BOULEVARD, SUITE 603 FRISCO, TX 75034 | UNITED STATES FIRE INSURANCE COMPANY | $16K | $0 | $16K | 5.68% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNITED STATES FIRE INSURANCE COMPANY | $2K | $0 | $2K | 0.77% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 | 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | AETNA LIFE INSURANCE CO. | $3K | $0 | $3K | 5.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | $215 | $0 | $215 | 0.33% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 19 EAST 200 SOUTH SALT LAKE CITY, UT 84111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.50% |
| ARDENA L MCVICKER3 Filed as: ARDENA L. MCVICKER | 73 KATYDID LANE MORGANTOWN, PA 19543 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $87 | $1K | 3.03% |
| CUSTOM INS SPEC & OTHER AGENTS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $264 | $0 | $264 | 0.73% |
| BRENT L GOODE3 Filed as: BRENT MCVICKER | 73 KATYDID LANE MORGANTOWN, PA 19543 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $242 | $5 | $247 | 0.68% |
| EDWARD P DOUGHERTY INC3 Filed as: EDWARD P. DOUGHERTY, INC. | 4550 PRESTWICK DRIVE READING, PA 19606 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $245 | $0 | $245 | 0.68% |
| CASEY H EBBERT3 Filed as: CASEY H. EBBERT | 465 LOCUST RUN DRIVE YORK, PA 17404 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | $0 | $201 | 0.55% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $180 | $15 | $195 | 0.54% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 | 555 FAIRMONT AVENUE TOWSON, MD 21286 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 13.40% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $4 | $0 | $4 | 0.02% |
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 | 200 | 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) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED STATES FIRE INSURANCE COMPANY | 24 | $275K |
| Dental | AETNA LIFE INSURANCE CO. | 209 | $66K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 199 | $58K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 35 | $36K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 199 | $22K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 199 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.