| 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 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 18.79% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 5.54% |
| DEBORAH NELSON3 | 625 FAIRVIEW ST SUITE 121 CARSON CITY, NV 89701 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 5.47% |
| ANGELA SCHIEK3 Filed as: ANGELA MEDINA | 9437 DOUBLE DIAMOND PARKWAY SUITE 17 RENO, NV 89521 | CONTINENTAL AMERICAN INSURANCE COMPANY | $842 | — | $842 | 2.49% |
| DEBORAH NELSON3 Filed as: DEBORAH YOUNG | 318 N CARSON STREET 104 CARSON CITY, CA 95763 | CONTINENTAL AMERICAN INSURANCE COMPANY | $531 | — | $531 | 1.57% |
| AMY M EDMONDS3 Filed as: AMY EDMONDS | PO BOX 6597 FOLSOM, CA 95763 | CONTINENTAL AMERICAN INSURANCE COMPANY | $148 | — | $148 | 0.44% |
| LISA A PERRI3 Filed as: LISA HUTCHERSON | 193 BLUE RAVINE RD SUITE 140 FOLSOM, CA 95630 | CONTINENTAL AMERICAN INSURANCE COMPANY | $33 | — | $33 | 0.10% |
| ROBERT PILKENTON3 | 1100 CORPORATE WAY SUITE 100 SACRAMENTO, CA 95831 | CONTINENTAL AMERICAN INSURANCE COMPANY | $33 | — | $33 | 0.10% |
| 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 | 14.80% |
| JEFFREY HENNINGSEN3 Filed as: JEFFREY BARBERIO | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | SPECTERA | $2K | — | $2K | 10.01% |
| ROGERS BENEFIT GROUP INC3 Filed as: RANDALL ROGERS | 5006 LYNDALE AVE SOUTH MINNEAPOLIS, MN 55419 | SPECTERA | $2K | — | $2K | 9.49% |
| CALIFORNA BENEFIT PLANS INC3 | 1850 NORTH CENTRAL AVENUE SUITE 2000 PHOENIX, AZ 85004 | SPECTERA | $1K | — | $1K | 4.97% |
| GARY WHITE3 | 26 PLACER DR DAHLONEGA, GA 30533 | SPECTERA | $224 | — | $224 | 0.99% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $572 | $3K | 18.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $19K |
| CBIZ BENEFITS AND INS SERVICES INC EIN 31-1582098 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
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 | 314 | 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) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SPECTERA | 196 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 314 | $93K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 80 | $34K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 59 | $24K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 314 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.