| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | BLUECROSS BLUESHIELD OF ILLINOIS | $52K | $2K | $53K | 4.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $639 | $4K | 5.52% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $77 | $24 | $101 | 0.13% |
| USI INSURANCE SERVICES LLC3 | 1 INTERNATIONAL PLAZA, STE 400 PHILADELPHIA, PA 19113 | METROPOLITAN LIFE INSURANCE COMPANY | — | $51 | $51 | 0.06% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 623886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $675 | — | $675 | 5.26% |
| USI INSURANCE SERVICES LLC3 | 308 N 21ST STREET SAINT LOUIS, MO 63103 | VISION SERVICE PLAN | $255 | — | $255 | 1.99% |
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 | 119 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 199 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 248 | $79K |
| Vision | VISION SERVICE PLAN | 121 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 248 | $79K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 248 | $149K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 248 | $149K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 199 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.