| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF TENNESSEE | $53K | — | $53K | 10.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $36K | $7K | $42K | 17.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $6K | $29K | 12.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $4K | $28K | 17.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | $4K | $25K | 17.70% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | DELTA DENTAL OF TENNESSEE | $12K | — | $12K | 10.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21K | $2K | $24K | 24.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $2K | $17K | 22.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CLEVELAND, OH 44131 | WELLFLEET INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| VELOCITY BENEFITS3 | 113 SILKY SULLIVAN WAY CANTON, GA 30115 | WELLFLEET INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| ROBERT S SHESTACK3 | 57 BOLZ CT MOUNT LAUREL, NC 08054 | WELLFLEET INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| CBIZ BENEFITS & INSURANCE SERVICES4 | 12 CADILLAC DRIVE SUITE 160 BRENTWOOD, TN 37027 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $7K | — | $7K | 17.00% |
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 | 1,129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF TENNESSEE | 1,490 | $527K |
| Vision | DELTA DENTAL OF TENNESSEE | 1,320 | $117K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,289 | $384K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 567 | $237K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 586 | $143K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,289 | $514K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,490 | — |
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.