| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 951 YAMATO ROAD SUITE 200W BOCA RATON, FL 33431 | FLORIDA BLUE | $0 | $10K | $10K | 2.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 2.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 2.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 2.46% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $607 | $607 | 2.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA EIN 59-2015694 ADMINISTRATOR | Contract Administrator Service code 13 | — | $362K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 ADMINISTRATIVE SERVICES | Named fiduciary; Participant communication; Other services; Non-monetary compensation; Contract Administrator; Direct payment from the plan; Float revenue; Claims processing Service code 12 | — | $40K |
| CBIZ BENEFITS & INSURANCE EIN 31-1582098 BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 818 | 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) | 818 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,047 | $45K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,239 | $226K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 821 | $154K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 914 | $169K |
| Stop-loss / reinsurancereinsurance | FLORIDA BLUE | 712 | $367K |
| Other(3 contracts, 2 carriers) | FLORIDA BLUE | 1,239 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,239 | — |
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.