| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3625 CUMBERLAND BLVD SE, SUITE 800 ONE OVERTON PARK ATLANTA, GA 30339 | BLUE CROSS AND BLUE SHIELD OF MONTANA | $58K | $5 | $58K | 3.09% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3625 CUMBERLAND BLVD SE, SUITE 800 ONE OVERTON PARK ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3625 CUMBERLAND BLVD SE, SUITE 800 ONE OVERTON PARK ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3625 CUMBERLAND BLVD SE, SUITE 800 ONE OVERTON PARK ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | DEARBORN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 3625 CUMBERLAND BLVD SE, SUITE 800 ONE OVERTON PARK ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM INSURANCE COMPANY | $387 | $52 | $439 | 5.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM INSURANCE COMPANY | $381 | $77 | $458 | 6.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM INSURANCE COMPANY | $296 | $67 | $363 | 7.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | AMERITAS LIFE INSURANCE COMPANY | $417 | — | $417 | 10.01% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE RD SUITE 206 ROSWELL, GA 30075 | AMERITAS LIFE INSURANCE COMPANY | $417 | — | $417 | 10.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | MANHATTAN LIFE | $141 | — | $141 | 12.52% |
| JAMES H. VAN EPPS3 | 10930 CRABAPPLE RD SUITE 206 ROSWELL, GA 30075 | MANHATTAN LIFE | $141 | — | $141 | 12.52% |
| CBIZ BENEFITS & INSURANCE SERVICES4 | 700 WEST 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | LEGALSHIELD | $172 | — | $172 | 17.00% |
| CBIZ BENEFITS & INSURANCE SERVICES4 | 700 WEST 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | LEGALSHIELD | $71 | — | $71 | 16.99% |
| CBIZ BENEFITS & INSURANCE SERVICES4 | 700 WEST 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | LEGALSHIELD | $49 | — | $49 | 18.28% |
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 | 365 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MONTANA | 255 | $1.9M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MONTANA | 255 | $1.9M |
| Vision(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 106 | $16K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 185 | $35K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 51 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 68 | $19K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MONTANA | 255 | $1.9M |
| Other(8 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 185 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.