| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $3K | $267 | $3K | 16.32% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN ACCOUNTING DEPT CINCINATI, OH 45263 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $437 | — | $437 | 2.52% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $865 | — | $865 | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $651 | — | $651 | 10.00% |
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 | 352 | 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) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 352 | $52K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 352 | $164K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 352 | $137K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 352 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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.