| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCES | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $36K | — | $36K | 0.86% |
| PETER J MACE3 | 5775 E GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 41.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCES | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $171 | $7K | $7K | 18.66% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP INC | 5775 E GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 6.85% |
| PETER J MACE3 | 5775 E GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | — | $15K | 57.78% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $201 | $7K | 26.60% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP INC | 5775 E GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 7.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $9K |
| CIGNA | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $0 |
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 | 1,106 | 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) | 1,106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 843 | $4.2M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 843 | $4.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 843 | $4.2M |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,030 | $178K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,030 | $77K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,030 | $77K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,030 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,030 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.