| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $368 | — | $368 | 2.36% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: NORTHWESTERN BENEFITS CORP. OF GA | 3438 PEACHTREE RD. NE PHILLIPS TOWER, SUITE 1100 ATLANTA, GA 30326 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 0.98% |
| KDL INSURANCE BENEFITS, INC.3 | 9085 BETHEL ROAD GAINSVILLE, GU 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.91% |
| SHERI L MITCHELL INC3 | 540 BIRNAMWOOD DRIVE SUWANEE, GA 30024 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | — | $103 | 0.66% |
| VINSON K ELLENBERG3 | 905 ADAIR AVE NE ATLANTA, GA 30306 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.55% |
| C MARIE ADAMS VOLK3 | 2295 OLD ORCHARD DRIVE MARIETTA, GA 30068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $64 | — | $64 | 0.41% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC. | 3730 EVEREST DR. MONTGOMERY, AL 36106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.24% |
| KENNETH B TORBETT3 | 453 BRUSHSTROKE CT MARIETTA, GA 30067 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.12% |
| MARIA VERONICA JARQUE3 | 4085 NOBEL DR #29 SAN DIEGO, CA 92122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.09% |
| BARBARA J LAKE3 | 226 N HIGH ST MORRISTOWN, IN 46161 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| DANA MARIE MOWATT3 | 23701 S. WESTERN AVENUE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.04% |
| LESLIE BUSSEY3 | P.O. BOX 725385 ATLANTA, GA 31139 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.03% |
| DEBRA E RUSSELL3 | 129 COLONIAL STREET SE PORT CHARLOTTE, FL 33952 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| SPECTRUM SOLUTIONS INC3 | 213 GOVERNOR WALK KATHLEEN, GA 31047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| LAURIE J BURNS3 | 303 PLYLER RD INDIAN TRAIL, NC 28079 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $688 | — | $688 | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS. SVCS., INC. | PO BOX 632886 CINCINNATI, OH 45263 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $223 | — | $223 | 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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $25K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 31 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $17K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.