| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $44K | $44K | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $3K | $5K | 4.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OK 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $278 | $6K | 10.59% |
| DAJOMA LLC3 Filed as: DAJOMA | 8370 VETERANS HWY SUITE 101 MILLERVILLE, MD 21108 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.77% |
| GEORGE KINIGOPOULOS3 Filed as: GEORGE S KINIGOPOULOS | 530 GAITHER ROAD SUITE 350 ROCKVILLE, MD 20850 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $236 | — | $236 | 2.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 22.40% |
| MATTHEW W EVANS3 | 127 BOONE TRIAL SEVERNA PARK, MD 21146 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 16.44% |
| DREW SKIBITSKY3 | 11285 DOVEDALE COURT MARRIOTTSVILLE, MD 21104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $294 | — | $294 | 3.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | FIRST UNUM LIFE INSURANCE COMPANY | — | $590 | $590 | 17.00% |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 273 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 122 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 119 | $112K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 119 | $112K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 339 | $70K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 339 | $60K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 122 | $2.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 339 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.