| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | HEALTH CARE SERVICE CORPORATION | $37K | $747 | $38K | 4.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $770 | $6K | 10.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC DBA SOURCE 1 BENEFITS | 206 S JEFFERSON ST, STE 200 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $195 | $3K | 4.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 11440 TOMAHAWK CREEK PARKWAY LEAWOOD, KS 66211 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $2K | — | $2K | 5.98% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 11440 TOMAHAWK CREEK PARKWAY LEAWOOD, KS 66211 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $943 | — | $943 | 5.87% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.79% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL DBA SOURCE 1 BENEFITS | 206 SOUTH JEFFERSON STREET CHICAGO, IL 60661 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $521 | — | $521 | 5.40% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $798 | $798 | 17.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 225 W WACKER DR, STE 2000 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $684 | — | $684 | 15.00% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 175 | $926K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $52K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 169 | $10K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 127 | $40K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 127 | $16K |
| Other(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 130 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.