| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 WEST 47TH ST SUITE 1100 KANSAS CITY, MO 64112 | MEDICAL MUTUAL OF OHIO | $37K | $3K | $40K | 2.76% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 | 13800 JACKSON RD MISHAWAKA, IN 46544 | COMMUNITY INSURANCE COMPANY | $14K | $2K | $15K | 2.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | RESERVE NATIONAL INSURANCE COMPANY | $7K | $0 | $7K | 7.89% |
| LAYNE FINANCIAL INC3 | 3009 WILMINGON RD SUITE 100 NEW CASTLE, PA 161051238 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 6.44% |
| BNYU LLC3 | 3009 WILMINGTON RD SUITE 100 NEW CASTLE, PA 161051238 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 5.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES | PO BOX 632886 CINCINNATI, OH 452632886 | PRINCIPAL LIFE INSURANCE COMPANY | $740 | $0 | $740 | 1.17% |
| YOST MICHAEL3 | PO BOX 14218 POLAND, OH 44514 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.09% |
| LAYNE FINANCIAL INC3 | 3009 WILMINGON RD SUITE 100 NEW CASTLE, PA 16105 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $772 | $0 | $772 | 5.03% |
| MONTECALVO ANDREA LYNN3 | 3338 DRAPER AVE SE WARREN, OH 44484 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | $0 | $6 | 0.04% |
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 | 112 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 107 | $2.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $63K |
| Vision(2 contracts, 2 carriers) | MEDICAL MUTUAL OF OHIO | 275 | $1.5M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $63K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $78K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 275 | $63K |
| Prescription drug | MEDICAL MUTUAL OF OHIO | 103 | $1.4M |
| Other | RESERVE NATIONAL INSURANCE COMPANY | 112 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.