| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES | $10K | — | $10K | 7.43% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. AND FIN. SVCS. | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES | $0 | $5K | $5K | 3.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES | $3K | $0 | $3K | 2.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 13.57% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. AND FIN. SVCS. | 1133 WESTCHESTER AVENUE, SUITE S229 WHITE PLAINS, NY 10604 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $935 | — | $935 | 4.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | $179 | $0 | $179 | 0.89% |
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 | 156 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILITATES | 160 | $138K |
| Vision | VISION SERVICE PLAN | 142 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 189 | $80K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 189 | $80K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 189 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.