| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS. | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $52K | — | $52K | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS. | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 10.88% |
| CBIZ BENEFITS & INSURANCE SERVICES5 Filed as: CBIZ BENEFITS | 2127 E. SPEEDWAY SUITE 110 TUCSON, AZ 85719 | TRANSAMERICA INSURANCE CO. | $28K | — | $28K | 21.90% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE CO. | $14K | — | $14K | 11.20% |
| EVOLVED BENEFITS5 | 2307 FENTON PKWY #107-126 SAN DIEGO, CA 92108 | TRANSAMERICA INSURANCE CO. | $6K | — | $6K | 4.38% |
| WEBTPA EMPLOYER SERVICES LLC5 Filed as: WEBTPA | 8500 FREEPORT PARKWAY SOUTH IRVING, TX 75063 | TRANSAMERICA INSURANCE CO. | $5K | — | $5K | 4.21% |
| PARAGON PARTNERS LMT.5 | 9420 E DOUBLETREE RANCH RD. STE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA INSURANCE CO. | $4K | — | $4K | 2.92% |
| IMPACT INTERACTIVE LLC5 Filed as: IMPACT INTERACTIVE | PO BOX 603188 CHARLOTTE, NC 28260 | TRANSAMERICA INSURANCE CO. | $2K | — | $2K | 1.38% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS. | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 9.87% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS. | 19 E 200 SOUTH STE 1000 SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.82% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS. | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS. | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $803 | — | $803 | 10.87% |
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 | 282 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 191 | $2.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 178 | $117K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 178 | $117K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 282 | $134K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 282 | $56K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 30 | $31K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 282 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.