| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP. | $3K | $4K | $7K | 3.71% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICE | $3K | — | $3K | 8.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $469 | — | $469 | 1.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $360 | — | $360 | 1.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| JORGENSEN HEALTHCARE ASSOC. EIN 86-0687859 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $21K |
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 | 609 | 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) | 609 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 609 | $220K |
| Vision(4 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 609 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.