| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVENUE WHITE PLAINS, NY 10604 | AETNA LIFE INSURANCE CO | $57K | — | $57K | 3.86% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS, INC | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO | $49K | $92 | $49K | 3.31% |
| LIFETIME BENEFIT SOLUTIONS, INC.3 | 2457 STATE RT 7, SUITE 1 PO BOX 340 COBLESKILL, NY 12043 | EXCELLUS BLUECROSS BLUESHIELD | $473 | — | $473 | 0.73% |
| CORNERSTONE INSURANCE & FINANCIAL3 Filed as: CORNERSTONE INSURANCE AND FINANCIAL | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $5K | $6K | 14.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | — | $1K | 2.56% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $4K | $6K | 15.19% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $929 | — | $929 | 2.44% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | COMPANION LIFE INSURANCE COMPANY | $886 | $3K | $4K | 14.66% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 4.09% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | MUTUAL OF OMAHA INSURANCE COMPANY | $152 | $510 | $662 | 15.62% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | MUTUAL OF OMAHA INSURANCE COMPANY | $272 | — | $272 | 6.42% |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 369 | $1.5M |
| Dental | AETNA LIFE INSURANCE CO | 369 | $1.5M |
| Vision | AETNA LIFE INSURANCE CO | 369 | $1.5M |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 200 | $28K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 219 | $41K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 218 | $38K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 9 | $65K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 0 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 369 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.