| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICESI | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 6.26% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV (NJ) | PO BX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $473 | — | $473 | 4.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC(OH) | P. O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $94 | — | $94 | 0.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV (NJ) | PO BX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $641 | — | $641 | 8.23% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC(OH) | P. O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $137 | — | $137 | 1.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $307 | — | $307 | 4.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV (NJ) | PO BX 632886 ATTN COMMISSIONS CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $579 | — | $579 | 8.41% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SRVC(OH) | P. O. BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $109 | — | $109 | 1.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | — | $76K |
| CIGNA | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation 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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 183 | $51K |
| Short-term disability(2 contracts) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 183 | $66K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 183 | $16K |
| Other(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 183 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.