| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2255 GLADES RD STE 118E BOCA RATON, FL 33431 | HEALTH OPTIONS | $37K | — | $37K | 2.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 2255 GLADES RD STE 118E BOCA RATON, FL 33431 | BLUE CROSS BLUE SHIELD OF FLORIDA | $23K | — | $23K | 2.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 721 EMERSON ROAD STE. 400 SAINT LOUIS, MO 63141 | GUARDIAN | $18K | — | $18K | 10.00% |
| MARK METTILLE3 Filed as: MARK STEPHEN METTILLE | 832 BAY ST SAINT PETERSBURG, FL 33701 | GUARDIAN | $8K | — | $8K | 4.20% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 12.63% |
| GIS OF ILLINOIS3 Filed as: GIS BENEFITS GA PURPOSES ONLY | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 6.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 13.19% |
| GIS OF ILLINOIS3 Filed as: GIS BENEFITS INC GA PURPOSES ONLY | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.86% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $960 | $3K | 13.06% |
| GIS OF ILLINOIS3 Filed as: GIS BENEFITS INC GA PURPOSES ONLY | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.80% |
| GIS OF ILLINOIS3 Filed as: GIS BENEFITS INC GA PURPOSES ONLY | 422 WAUPONSEE ST MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $928 | $928 | 3.95% |
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 | 334 | 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) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 195 | $2.6M |
| Dental | GUARDIAN | 247 | $183K |
| Vision | GUARDIAN | 247 | $183K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 334 | $80K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 89 | $24K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 195 | $2.6M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 334 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 334 | — |
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."
No prospect flags tripped on this filing.