| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | HEALTH CARE SERVICE CORPORATION | $172K | $2K | $174K | 5.38% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT & INSURANCE SERVICES | 55 SHUMAN BLVD SUITE 550 NAPERVILLE, IL 60563 | KAISER FOUNDATION HEALTH PLAN INC | $12K | — | $12K | 2.40% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2255 GLADES ROAD SUITE 321A BOCA RATON, FL 33431 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INSURANCE ADMIN | 721 S PARKER ST SUITE 200 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | DEARBORN LIFE INSURANCE COMPANY | $18K | — | $18K | 12.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 721 EMERSON ROAD SUITE 400 ST LOUIS, MO 63141 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 14.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 3632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | $10K | $28K | 26.71% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC DBA SOURSE 1 BENEFITS | 216 S JEFFERSON ST, STE LL2 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 5.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W. 47TH STREET KANSAS CITY, MO 64112 | ARAG INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 283 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH CARE SERVICE CORPORATION | 480 | $3.7M |
| Dental(2 contracts, 2 carriers) | HEALTH CARE SERVICE CORPORATION | 480 | $3.3M |
| Vision(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 370 | $243K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 370 | $242K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 295 | $106K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 295 | $106K |
| Other(4 contracts, 4 carriers) | DEARBORN LIFE INSURANCE COMPANY | 370 | $364K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 480 | — |
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.