| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $20K | — | $20K | 8.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $34 | $4K | 5.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.33% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 14.27% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $992 | $3K | 14.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $998 | $4K | 19.45% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 7.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $379 | $1K | 20.55% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH ST STE 100 KANSAS CITY, MO 64112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $792 | $248 | $1K | 19.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $51K |
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 | 233 | 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) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 98 | $225K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 233 | $86K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 239 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $46K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $27K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.