| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP | $3K | $2K | $5K | 2.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $5K | $20K | 13.58% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $4K | $14K | 13.57% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP | $1K | $2K | $3K | 4.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 18.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 13.56% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $619 | — | $619 | 1.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $583 | $2K | 13.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP | $260 | $2K | $2K | 15.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $423 | $2K | 13.54% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W. 47TH ST STE 1100 KANSAS CITY, MO 641121922 | AMERITAS LIFE INSURANCE CORP | $74 | $2K | $2K | 29.59% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $541 | $188 | $729 | 13.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | P.O. BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $72 | — | $72 | 1.79% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $388 | $82 | $470 | 18.15% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | VISION SERVICE PLAN | $3 | — | $3 | 1.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $235K |
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 | 548 | 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) | 548 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts) | AMERITAS LIFE INSURANCE CORP | 514 | $299K |
| Vision(7 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 514 | $337K |
| Life insurance(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $112K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $163K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $119K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.