| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BEEFITS & INSURANCE | PO BOX 632886 CINCINNATI, OH 45253 | CIGNA HEALTH & LIFE INSURANCE | $15K | $36K | $50K | 3.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $1K | $8K | 10.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $7K | 9.88% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $686 | $6K | 11.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | — | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 14.69% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $660 | $93 | $753 | 10.55% |
| BONNIE S HEMBROCK3 | 175 S WEST TEMPLE SALT LAKE CITY, UT 84101 | ZURICH AMERICAN LIFE INSURANCE COMPANY | $128 | — | $128 | 10.04% |
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 | 265 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH & LIFE INSURANCE | 178 | $1.5M |
| Dental | CIGNA HEALTH & LIFE INSURANCE | 178 | $1.4M |
| Vision | CIGNA HEALTH & LIFE INSURANCE | 178 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 254 | $77K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 404 | $78K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 404 | $55K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 11 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 404 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.