| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE COMPANY | $40K | — | $40K | 6.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 6160 GOLDEN HILLS DRIVE MINNEAPOLIS, MN 55416 | AETNA LIFE INSURANCE COMPANY | $9K | — | $9K | 1.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICES, | PO BOX 632886 CINCINNATI, OH 45263 | PREFERREDONE INSURANCE COMPANY | $4K | — | $4K | 1.02% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 6160 GOLDEN HILLS DRIVE MINNEPOLIS, MN 55416 | PREFERREDONE INSURANCE COMPANY | $4K | — | $4K | 1.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 11440 TOMAHAWK CREEK PARKWAY LEAWOOD, KS 66211 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $6K | — | $6K | 2.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ MINNEAPOLIS, MN | PO BOX 632886 CINCINNATI, OH 45263 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $7K | — | $7K | 4.60% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 6160 GOLDEN HILLS DRIVE MINNEAPOLIS, MN 55416 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | — | $4K | 3.09% |
| SEE ATTACHED3 | — | CONTINENTAL AMERICAN INSURANCE COMPANY | $30K | — | $30K | 23.02% |
| JANE K GATES4 | 255 KELLOGG BLVD E APT 304 SAINT PAUL, MN 55101 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $3K | — | $3K | 26.52% |
| KEVIN MCDANIELS4 | N8393 125 1ST ST RIVER FALLS, WI 54022 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $629 | — | $629 | 6.07% |
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 | 1,267 | 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) | 1,267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PREFERREDONE INSURANCE COMPANY | 32 | $694K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,429 | $144K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 1,267 | $629K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,267 | $629K |
| Prescription drug(2 contracts, 2 carriers) | PREFERREDONE INSURANCE COMPANY | 32 | $694K |
| Other(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,267 | $801K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,429 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.