| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF MINNESOTA | $5K | — | $5K | 9.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 6.93% |
| AUSMAN BRIDGET3 Filed as: AUSMAN, BRIDGET | 1086 HOWARD STREET SAN FRANCISCO, CA 94103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $996 | — | $996 | 3.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $742 | $742 | 2.24% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $657 | $657 | 2.25% |
| GROVE, MARC, A3 | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $686 | — | $686 | 3.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $579 | — | $579 | 3.25% |
| SMITH, THOMAS, CHRISTOPHER3 | P.O. BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $285 | — | $285 | 1.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $11 | $11 | 0.06% |
| GROVE, MARC, A3 | 25900 AUTUMN WAY ROGERS, MN 55374 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $290 | — | $290 | 3.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $232 | — | $232 | 3.14% |
| SMITH, THOMAS, CHRISTOPHER3 | P.O. BOX 6650 METAIRIE, LA 70009 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 1.46% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4 | $4 | 0.05% |
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 | 217 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 153 | $57K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $62K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 21 | $7K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $33K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.