| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SER | PO BOX 632886 CINCINNATI, OH 45263 | AETNA LIFE INSURANCE CO. | — | $5K | $5K | 0.76% |
| MVI ADMINISTRATORS, INC.5 | 1011 CAMINO DEL RIO SOUTH STE 300 SAN DIEGO, CA 92108 | KAISER FOUNDATION HEALTH PLAN INC | $30K | — | $30K | 4.84% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SER | PO BOX 632886 CINCINNATI, OH 452632886 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 1.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MVI ADMINISTRATORS, INC EIN 33-0393692 ADMINISTRATOR | Plan Administrator Service code 14 | 1011 CAMINO DEL RIO SOUTH STE 300 SAN DIEGO, CA 92108 | $54K |
| CBIZ BENEFITS & INSURANCE SERVICES, EIN 31-1582098 INSURANCE | Insurance brokerage commissions and fees Service code 53 | PO BOX 632886 CINCINNATI, OH 452632886 | $42K |
| LEAF & COLE, LLP EIN 95-2076568 AUDITOR | Accounting (including auditing) Service code 10 | 2810 CAMINIO DEL RIO SOUTH 200 SAN DIEGO, CA 921083820 | $12K |
| MELISSA W. COOK & ASSOCIATES EIN 95-3245809 ATTORNEY | Legal Service code 29 | 3444 CAMINO DEL RIO NORTH SUITE 10 SAN DIEGO, CA 92108 | $8K |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 115 | $1.3M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 929 | $144K |
| Vision | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 929 | $144K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 929 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 929 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.