| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | 700 W. 47TH ST. SUITE 1100 KANSAS CITY, MO 64112 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $75K | $290 | $75K | 2.79% |
| JET EMPLOYEE BENEFITS3 | 153 E. FLAGLER ST. #228 MIAMI, FL 33131 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $6K | — | $6K | 0.22% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | SUN LIFE ASSURANCE COMPANY OF CANADA | $48K | — | $48K | 10.64% |
| JET EMPLOYEE BENEFITS3 Filed as: JET EMPLOYEE BENEFIT | 153 E. FLAGLER ST. #228 MIAMI, FL 33131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | — | $23K | 5.02% |
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 | 324 | 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) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 629 | $2.7M |
| Dental(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 629 | $3.1M |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 629 | $3.1M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 324 | $454K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 324 | $454K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 324 | $454K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 324 | $454K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 629 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.