| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | 3625 CUMBERLAND BLVD SUITE 1100 ATLANTA, GA 30339 | THE STANDARD INSURANCE COMPANY | $8K | — | $8K | 8.32% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ILLINOIS | FOUR WESTBROOK CORPORATE CENTE STE 500 WESTCHESTER, IL 60154 | DEARBORN LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 3625 CUMBERLAND BLVD SUITE 1100 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC D/B/A SOURCE 1 BENEFI | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $222 | $2K | 13.37% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ILLINOIS LLC | 4350 WEAVER PKWY WARRENVILLE, IL 60555 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $465 | $2K | 11.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | 3625 CUMBERLAND BLVD SUITE 1100 KANSAS CITY, KS 66211 | STANDARD INSURANCE COMPANY | $413 | — | $413 | 8.30% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | EYEMED VISION CARE | $269 | — | $269 | 6.59% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ILLINOIS LLC | 4350 WEAVER PKWY WARRENVILLE, IL 60555 | EYEMED VISION CARE | $136 | — | $136 | 3.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL DBA SOURCE 1 BENEFITS | 216 S JEFFERSON ST STE LL2 CHICAGO, IL 60661 | EYEMED VISION CARE | $135 | — | $135 | 3.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $177 | $21 | $198 | 13.14% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF ILLINOIS LLC | 4350 WEAVER PKWY WARRENVILLE, IA 60555 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $124 | $44 | $168 | 11.15% |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUECROSS BLUESHIELD | 211 | $2.2M |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD | 290 | $204K |
| Vision(3 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 254 | $49K |
| Life insurance(4 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 222 | $82K |
| Other(5 contracts, 4 carriers) | DEARBORN LIFE INSURANCE COMPANY | 239 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.