| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | $172K | $3K | $175K | 6.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W. SANTA CLARA ST, STE 450 SAN JOSE, CA 95113 | AETNA LIFE INSURANCE CO. | — | $165 | $165 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | AETNA HEALTH, INC. | $40K | — | $40K | 5.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | — | $17K | 20.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 4.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 84 S FIRST ST SAN JOSE, CA 95113 | HARTFORD LIFE AND ACCIDENT | $563 | — | $563 | 15.01% |
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 | 266 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 447 | $2.8M |
| Dental | AETNA LIFE INSURANCE CO. | 447 | $2.8M |
| Vision | VISION SERVICE PLAN | 253 | $33K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 261 | $87K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 266 | $40K |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 266 | $91K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.