| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS -MN | PO BOX 632886 CINCINNATI, OH 45263 | MEDICA INSURANCE COMPANY | $59K | $2K | $61K | 3.11% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL ST - FL 4 BOSTON, MA 02110 | MEDICA INSURANCE COMPANY | $32K | — | $32K | 1.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVCS-MO | PO BOX 632886 CINCINNATI, OH 45263 | MEDICA INSURANCE COMPANY | $6K | $2K | $8K | 0.40% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $838 | $2K | 8.85% |
| GIS BENEFITS INC5 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC.-DALLAS | 160 FEDERAL ST - FL 4 BOSTON, MA 02110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $630 | — | $630 | 2.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.17% |
| GIS BENEFITS INC5 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC.-DALLAS | 160 FEDERAL ST-FL 4 BOSTON, MA 02110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.78% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SERVICE, INC | PO BOX 632886 CINCINNATI, OH 45263 | HEALTH VENURES NETWORK | $2K | — | $2K | 8.33% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | HEALTH VENURES NETWORK | $306 | — | $306 | 1.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $755 | $466 | $1K | 8.79% |
| GIS BENEFITS INC5 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $695 | $695 | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC.-DALLAS | 160 FEDERAL STREET, FL 4 BOSTON, MA 02110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $356 | — | $356 | 2.56% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $524 | $280 | $804 | 10.45% |
| GIS BENEFITS INC5 | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $385 | $385 | 5.00% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC.-DALLAS | 160 FEDERAL ST - FL 4 BOSTON, MA 02110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $246 | — | $246 | 3.20% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 240 | $2.0M |
| Vision | HEALTH VENURES NETWORK | 218 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $32K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $14K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.