| 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 CONCORDIA INSURANCE COMPANY | $7K | — | $7K | 6.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $10K | 14.92% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 16.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC. | PO BOX 632886 CINCINNATI, OH 45263 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 17.08% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $817 | $3K | 14.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $764 | $2K | 14.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 3530 TORINGDON, SUITE 100 CHARLOTTE, NC 28277 | STARMOUNT LIFE INSURANCE COMPANY | $738 | — | $738 | 11.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Claims processing Service code 12 | — | -$62K |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 197 | $486K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 294 | $110K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 0 | $6K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $62K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $87K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $16K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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.