| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS, INC | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | BLUE CROSS OF CALIFORNIA | $82K | $851 | $83K | 4.60% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | BLUE CROSS OF CALIFORNIA | $12K | $0 | $12K | 0.68% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 5200 NORTH PALM AVENUE, SUITE 114 FRESNO, CA 93704 | BLUE CROSS OF CALIFORNIA | $4K | $0 | $4K | 0.23% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS, INC | 2290 LUCIEN WAY, SUITE 205 MAITLAND, FL 32751 | ANTHEM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 13.85% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | ANTHEM LIFE INSURANCE COMPANY | $485 | $0 | $485 | 1.57% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DRIVE, SUITE 305 ELMWOOD PARK, NJ 07407 | ANTHEM LIFE INSURANCE COMPANY | $86 | $0 | $86 | 0.28% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | ANTHEM LIFE INSURANCE COMPANY | $276 | $0 | $276 | — |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS, INC | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | ANTHEM LIFE INSURANCE COMPANY | $106 | $0 | $106 | — |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Dental | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Vision | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Life insurance(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 168 | $31K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 257 | $1.8M |
| Other(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 168 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.