| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 318 BEAR HILL ROAD WALTHAM, MA 02451 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $139K | $30K | $169K | 3.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $31K | $4K | $34K | 3.34% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 12 GILL STREET, SUITE 500 WOBURN, MA 01801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24 | $24 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 3716 NORFOLK, VA 23514 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24 | $24 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 160 WEST SANTA CLARA, SUITE 450 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $2K | — | $2K | 4.11% |
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 | 1,583 | 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) | 1,583 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 976 | $5.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,797 | $1.0M |
| Vision | VISION SERVICE PLAN | 435 | $43K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,797 | $1.0M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,797 | $1.0M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,797 | $1.0M |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 976 | $5.8M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,797 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,797 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.