| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 3.66% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | METROPOLITAN LIFE INSURANCE COMPANY | — | $17 | $17 | 0.01% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | RELIANCE STANDARD | $1K | — | $1K | 2.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | RELIANCE STANDARD | $873 | — | $873 | 1.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | RELIANCE STANDARD | $697 | — | $697 | 2.03% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | RELIANCE STANDARD | $678 | — | $678 | 1.97% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | RELIANCE STANDARD | $51 | — | $51 | — |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 452632886 | RELIANCE STANDARD | $37 | — | $37 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SYMETRA FINANCIAL EIN 91-0742147 NONE | Insurance services Service code 23 | — | $666K |
| THE LOOMIS COMPANY EIN 23-2238132 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $61K |
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | — | $27K |
| CBIZ EIN 31-1582098 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | — | $24K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Other services Service code 49 | — | $8K |
| ZELIS CLAIMS INTEGRITY, INC. EIN 86-1040704 NONE | Other services Service code 49 | — | $7K |
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 | 186 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 367 | $135K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 198 | $13K |
| Life insurance | RELIANCE STANDARD | 186 | $52K |
| Long-term disability | RELIANCE STANDARD | 186 | $34K |
| Other(2 contracts) | RELIANCE STANDARD | 186 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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."
No prospect flags tripped on this filing.