| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $114K | $429 | $115K | 2.79% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2255 GLADES RD SUITE 321A BOCA RATON, FL 33431 | KAISER FOUNDATION HEALTH PLAN INC. | $25K | — | $25K | 2.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA SUITE 450 SAN JOSE, CA 95113 | SUTTER HEALTH PLAN | $13K | — | $13K | 2.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2290 LUCIEN WAY SUITE 205 MAITLAND, FL 32751 | ANTHEM LIFE INSURANCE COMPANY | $6K | — | $6K | 5.29% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2290 LUCIEN WAY SUITE 205 MAITLAND, FL 32751 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 6.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2290 LUCIEN WAY SUITE 205 MAITLAND, FL 32751 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 9.06% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINATTI, OH 45623 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $289 | — | $289 | 3.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $240 | — | $240 | 3.12% |
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 | 622 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 624 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 129 | $1.6M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 720 | $4.1M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 720 | $4.1M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 659 | $118K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 96 | $18K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 86 | $45K |
| Prescription drug | SUTTER HEALTH PLAN | 61 | $579K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 659 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 720 | — |
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."
No prospect flags tripped on this filing.