| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 452632886 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | $71K | $78K | 2.30% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $48K | $13K | $61K | 4.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ M.T. DONAHOE AND ASSOCIATES | 9755 PATUXENT WOODS DR SUITE 250 COLUMBIA, MD 21046 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $19K | — | $19K | 1.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W. SANTA CLARA STREET STE 450 SAN JOSE, CA 951131762 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $1 | $4K | 3.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 10.03% |
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 | 338 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 300 | $4.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 300 | $3.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 354 | $37K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 348 | $3.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.