| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $139K | $151K | 3.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC( | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 13.78% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFIT & INS SERVICES, INC. | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $39 | $2K | 4.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC | PO BOX 32886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 13.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC | P. O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 13.73% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $758 | — | $758 | 10.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $21 | — | $21 | 10.19% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19 | — | $19 | 10.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS ADMINISTRATION | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $4K |
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 | 744 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 744 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 500 | $5.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 500 | $5.0M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 709 | $47K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 791 | $283K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 734 | $195K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 353 | $68K |
| Other(6 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 221 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 791 | — |
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.