| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED HEALTH CARE INSURANCE COMPANY | — | $43K | $43K | 7.28% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 3800 N CENTRAL AVE FLOOR 9 PHOENIX, AZ 85012 | UNITED HEALTH CARE INSURANCE COMPANY | $14K | $7K | $21K | 3.60% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | $3K | — | $3K | 7.32% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 14.65% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICE INC | PO BOX 632886 CINCINNATI, OH 45263 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.30% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC., INC. | 3800 N. CENTRAL AVE., 9TH FL PHOENIX, AZ 85012 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.90% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC., INC. | 3800 N. CENTRAL AVE., 9TH FL PHOENIX, AZ 85012 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $921 | $921 | 5.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC., INC. | 3800 N. CENTRAL AVE., 9TH FL PHOENIX, AZ 85012 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $936 | $936 | 6.05% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC., INC. | 3800 N. CENTRAL AVE., 9TH FL PHOENIX, AZ 85012 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $517 | $517 | 6.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC. | 3800 N CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $280 | $49 | $329 | 7.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $107 | — | $107 | 2.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N. CENTRAL AVE 9TH FLOOR PHOENIX, AZ 85012 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $131 | $19 | $150 | 10.52% |
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 | 216 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTH CARE INSURANCE COMPANY | 106 | $594K |
| Dental | AMERICAN NATIONAL INSURANCE COMPANY OF TEXAS | 119 | $44K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 216 | $17K |
| Life insurance(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $32K |
| Short-term disability(2 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 24 | $13K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 140 | $16K |
| Other(3 contracts) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 139 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.