| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $485 | $2K | 4.98% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 460325638 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $776 | — | $776 | 2.14% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $829 | $524 | $1K | 9.06% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 460325638 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $664 | — | $664 | 4.45% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $963 | $494 | $1K | 12.04% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 460325638 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $853 | — | $853 | 7.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $911 | $396 | $1K | 11.34% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE, LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 460325638 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $818 | — | $818 | 7.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 452632886 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $372 | — | $372 | 3.47% |
| ASSUREDPARTNERS3 Filed as: SHEPHERD INSURANCE LLC | 111 CONGRESSIONAL BLVD SUITE 100 CARMEL, IN 46032 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $352 | — | $352 | 3.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $48K | — | $48K | 1499.94% |
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 | 161 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 4 | $36K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 169 | $11K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $12K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.