| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $23K | — | $23K | 5.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA STREET, SUITE 450 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 3.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 160 W SANTA CLARA ST, SUITE 450 SAM JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 4.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | PROMINENCE HEALTH PLAN | $20K | — | $20K | 10.63% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 4.93% |
| VARIOUS - SEE ATTACHMENT3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $8K | $472 | $9K | 26.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | KAISER FOUNDATION HEALTH PLAN OF NORTHWEST | $469 | — | $469 | 2.59% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | EYEMED VISION CARE | $1K | — | $1K | 9.22% |
| JOHNSON RESOURCES3 Filed as: JOHNSON RESOURCES - AZ | 7373 E DOUBLETREE RANCH, SUITE 200 SCOTTSDALE, AZ 85258 | EYEMED VISION CARE | $270 | — | $270 | 1.75% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | HEALTH CARE SERVICES CORPORATION | $210 | $75 | $285 | 2.71% |
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 | 215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 86 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 174 | $78K |
| Vision | EYEMED VISION CARE | 207 | $15K |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 205 | $15K |
| Short-term disability | AFLAC | 56 | $33K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 205 | $15K |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 86 | $1.2M |
| Other(2 contracts, 2 carriers) | AFLAC | 205 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.