| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | P.O. BOX 632886 CINCINNATI, OH 45263 | BLUE CROSS OF CALIFORNIA | $27K | — | $27K | 5.03% |
| AMWINS3 Filed as: LISI, INC. | 1600 WEST HILLSDALE BOULEVARD SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $13K | $13K | 2.51% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | HEALTH PLAN OF NEVADA | $11K | — | $11K | 5.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | HEALTH PLAN OF NEVADA | -$24 | — | -$24 | -5.08% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 199 | $744K |
| Dental(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 199 | $744K |
| Vision | BLUE CROSS OF CALIFORNIA | 199 | $530K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 199 | $530K |
| Prescription drug(2 contracts) | HEALTH PLAN OF NEVADA | 72 | $214K |
| Other | BLUE CROSS OF CALIFORNIA | 199 | $530K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.