| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | — | UNITED HEALTHCARE | $756 | — | $756 | 0.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | — | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | — | LIFE INSURANCE COMPANY FO NORTH AMERICA | $2K | — | $2K | 6.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.87% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $829 | — | $829 | 5.97% |
| CBIZ BENEFITS & INSURANCE SERVICES5 | — | VSP VISION CARE | $604 | — | $604 | 7.88% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 19 E 200 SOUTH SALT LAKE CITY, UT 84111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $68 | — | $68 | 4.88% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SBMA EIN 81-1242192 TPA | Plan Administrator Service code 14 | — | $0 |
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 | 244 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ALABAMA | 110 | $1.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 145 | $41K |
| Vision | VSP VISION CARE | 51 | $8K |
| Life insurance | LIFE INSURANCE COMPANY FO NORTH AMERICA | 59 | $27K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 62 | $25K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 42 | $14K |
| Prescription drug | BLUE CROSS & BLUE SHIELD OF ALABAMA | 110 | $997K |
| Other(3 contracts, 2 carriers) | BLUE CROSS & BLUE SHIELD OF ALABAMA | 110 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.