| 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 | $60K | $19K | $79K | 2.87% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | — | $31K | 1.13% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $93K | — | $93K | 10.72% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $1K | $29K | 3.36% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERV | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $27K | $27K | 3.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | P O BOX 632885 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | — | $29K | 11.39% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $9K | $9K | 3.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $352 | $7K | 2.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.69% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $684 | $51 | $735 | 3.51% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $666 | $666 | 3.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERV | P O BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $715 | — | $715 | 6.83% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $332 | $25 | $357 | 3.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $319 | $319 | 3.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE | P O BOX 632886 CINCINNATI, OH 45263 | FIRST UNUM LIFE INSURANCE COMPANY | $680 | — | $680 | 14.22% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | FIRST UNUM LIFE INSURANCE COMPANY | $189 | $10 | $199 | 4.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | FIRST UNUM LIFE INSURANCE COMPANY | — | $141 | $141 | 2.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Direct payment from the plan; Claims processing; Float revenue; Participant communication; Named fiduciary; Contract Administrator; Non-monetary compensation; Other services Service code 12 | — | $27K |
| CIGNA | Contract Administrator; Non-monetary compensation; Named fiduciary; Participant communication; Claims processing; Other services; Float revenue; Direct payment from the plan 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 | 925 | 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) | 925 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,885 | $2.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,885 | $2.8M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,885 | $2.8M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,853 | $1.1M |
| Short-term disability(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,853 | $899K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,853 | $868K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,885 | $2.8M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,853 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,885 | — |
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.