| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP. | $5K | — | $5K | 2.48% |
| PRINCIPAL DENTAL SERVICES INC3 Filed as: PRINCIPAL DENTAL SERVICES INC. | 3430 EAST SUNRISE DRIVE SUITE 160 TUCSON, AZ 857183239 | AMERITAS LIFE INSURANCE CORP. | $195 | — | $195 | 0.10% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 452632886 | EMPLOYERS DENTAL SERVICES | $2K | — | $2K | 7.97% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $504 | — | $504 | 1.81% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $400 | — | $400 | 1.81% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $10 | — | $10 | 2.04% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $3 | — | $3 | 1.90% |
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 | 458 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 657 | $217K |
| Vision(5 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 657 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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."
No prospect flags tripped on this filing.