| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | MEDICAL MUTUAL | $34K | $62 | $34K | 2.82% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 5450 FRANTZ ROAD DUBLIN, OH 43016 | DELTA DENTAL OF OHIO | $4K | $141 | $4K | 4.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 14.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $657 | — | $657 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $946 | — | $946 | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $701 | — | $701 | 14.99% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 113 | $1.2M |
| Dental | DELTA DENTAL OF OHIO | 258 | $80K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 243 | $14K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 216 | $44K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 68 | $34K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 166 | $16K |
| Prescription drug | MEDICAL MUTUAL | 113 | $1.2M |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 167 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.