| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ MT DONAHOE & ASSOC, LLC | 9755 PATUXENT WOODS DR STE 250 COLUMBIA, MD 21046 | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | $21K | $1K | $23K | 1.25% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 4.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 11.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $966 | $7K | 15.90% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 11.58% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $856 | $4K | 12.27% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $1K | — | $1K | 5.99% |
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 | 207 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 142 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 440 | $131K |
| Vision | VISION SERVICE PLAN | 138 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $77K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $47K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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.