| 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 | $40K | $2 | $40K | 2.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $147 | $6K | 4.74% |
| 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 | $4K | — | $4K | 15.31% |
| 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% |
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 | 367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MONTANA | 249 | $1.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 134 | $121K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 134 | $121K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 367 | $51K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 76 | $23K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $22K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MONTANA | 249 | $1.4M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 367 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.