| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | 5450 FRANTZ RD DUBLIN, OH 43016 | DELTA DENTAL OF TENNESSEE | $12K | — | $12K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 9.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 15.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST SUITE 1100 21ST FLOOR KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $782 | $7K | 18.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | 5450 FRANTZ RD DUBLIN, OH 43016 | DELTA DENTAL OF TENNESSEE | $3K | — | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM INSURANCE COMPANY | $2K | — | $2K | 9.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINATTI, OH 45623 | UNUM INSURANCE COMPANY | $968 | — | $968 | 4.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST SUITE 1100 KANSAS CITY, MO 64112 | UNUM INSURANCE COMPANY | — | $252 | $252 | 1.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | — | $184 | $184 | 0.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINATTI, OH 45623 | UNUM INSURANCE COMPANY | $2K | — | $2K | 16.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST SUITE 1100 KANSAS CITY, MO 64112 | UNUM INSURANCE COMPANY | — | $179 | $179 | 1.86% |
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 | 385 | 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) | 385 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF TENNESSEE | 566 | $116K |
| Vision | DELTA DENTAL OF TENNESSEE | 436 | $26K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 427 | $110K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $65K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 427 | $75K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 427 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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.