| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $50K | $6K | $56K | 5.77% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST, STE 450 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 2.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | $15K | $1K | $16K | 5.69% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS FINANCIAL SVCS | 4851 LBJ FREEWAY, STE 100 DALLAS, TX 75244 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 2.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST, STE 450 SAN JOSE, CA 95113 | AETNA LIFE INSURANCE CO. | — | $114 | $114 | 0.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $2K | — | $2K | 3.16% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 249 | $2.3M |
| Dental | AETNA LIFE INSURANCE CO. | 510 | $279K |
| Vision | VISION SERVICE PLAN | 254 | $65K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 249 | $972K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 249 | $37K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 249 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 510 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.