| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | $85 | — | $85 | 0.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERV | 951 YAMATO RD. SUITE 200W BOCA RATON, FL 33431 | GUARDIAN | $18K | — | $18K | 5.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ | PO BOX 632886 CINCINNATI, OH 45263 | UNION SECURITY INSURANCE COMPANY | $39K | — | $39K | 14.09% |
| ANDREA MORTENSON3 | UNIT 273 16211 N. SCOTTSDALE RD SCOTTSDALE, AZ 85254 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $7K | — | $7K | 29.46% |
| DON ROMANS3 | 3200 RENWOOD BLVD APT 202 LOUISVILLE, KY 40214 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $44 | — | $44 | 0.19% |
| EAGLE ENTERPRISES LLC3 Filed as: EAGLE SUCCESS TEAM LLC | 2122 CEBOLLA CREEK WAY NW ALBUQUERQUE, NM 87120 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $33 | — | $33 | 0.14% |
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 | 739 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 739 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1,037 | $5.3M |
| Dental | GUARDIAN | 739 | $343K |
| Vision | GUARDIAN | 739 | $343K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 358 | $278K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 358 | $278K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 358 | $278K |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 358 | $301K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,037 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.