| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $70K | — | $70K | 8.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO POX 632886 CINCINNATI, OH 452632886 | AMERITAS LIFE INSURANCE CORP. | $23K | — | $23K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $15K | — | $15K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 452632886 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | — | $8K | 20.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS | PO BOX 632886 CINCINNATI, OH 452632886 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 20.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: BRUCE GRANT-CBIZ BENEFITS & INS SVC | 1765 E SKYLINE DRIVE TUCSON, AZ 85718 | UNITED HEALTHCARE INSURANCE COMPANY | $302 | — | $302 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $82K |
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 | 473 | 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) | 473 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 473 | $813K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 506 | $226K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 506 | $226K |
| Life insurance | STANDARD INSURANCE COMPANY | 262 | $146K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 262 | $103K |
| Long-term disability | STANDARD INSURANCE COMPANY | 262 | $62K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 89 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 506 | — |
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.