| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC - MID-ATLANT | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.24% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.19% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW RD FL 14 CHARLOTTE, NC 28210 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $996 | $3K | 13.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC - MID-ATLANT | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.27% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.76% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC MID-ATLANTIC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $960 | $0 | $960 | 5.24% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $698 | $698 | 3.81% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $659 | $2K | 13.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC - MID-ATLANT | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $941 | $0 | $941 | 5.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $630 | $0 | $630 | 4.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $409 | $0 | $409 | 3.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN EIN 16-1264154 ADMIN | Claims processing Service code 12 | — | $115K |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 169 | $69K |
| Vision | VISION SERVICE PLAN | 99 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $42K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 151 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $17K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.