| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | 11440 TOMAHAWK CREEK PARKWAY LEAWOOD, KS 66211 | BLUE CROSS AND BLUE SHIELD OF KANSAS CITY | $39K | $180K | $219K | 2.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 1.70% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $396 | $396 | 0.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W. 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | $3K | $19K | 13.70% |
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 | 1,088 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 39 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS CITY | 2,064 | $10.1M |
| Dental | DELTA DENTAL OF MISSOURI | 2,111 | $787K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 1,900 | $71K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,085 | $884K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,085 | $884K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,085 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,111 | — |
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.