| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERV. | PO BOX 1395 CLEVELAND, TN 37364 | SYMETRA LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| ASSUREDPARTNERS3 Filed as: GIS BENFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SYMETRA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 9.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERV. | 721 EMERSON RD STE 400 ST LOUIS, MO 63141 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 10.00% |
| MARK S METTILLE3 | 107 CANDLELIGHT LANE MORRIS, IL 60450 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 1395 CLEVELAND, TN 37364 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 20.81% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.20% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 123 | $66K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 123 | $66K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 153 | $83K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 153 | $83K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 153 | $83K |
| Other(2 contracts) | SYMETRA LIFE INSURANCE COMPANY | 153 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.