| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOC | 4740 CORRIDOR PLACE STE B BELTSVILLE, MD 20705 | CAREFIRST BLUE CHOICE | $72K | $15K | $87K | 4.23% |
| POTOMAC BASIN GROUP ASSOCIATES LLC5 Filed as: POTOMAC BASIN GROUP ASSOC | 4740 CORRIDOR PL STE B BELTSVILLE, MD 20705 | CAREFIRST BLUE CHOICE | $0 | $17K | $17K | 0.81% |
| POTOMAC BASIN GROUP ASSOCIATES LLC5 Filed as: POTOMAC BASIN GROUP ASSOCIATES | 4740 CORRIDOR PLACE STE B BELTSVILLE, MD 20705 | DOMINION NATIONAL | $20K | $0 | $20K | 11.62% |
| POTOMAC BASSIN GROUP ASSOC LLC3 Filed as: POTOMAC BASIC GROUP ASSOC LLC | 4740 CORRIDOR PL STE B BELTSVILLE, MD 20705 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $384 | $9K | 7.42% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOC LLC | 4740 CORRIDOR PL STE B BELTSVILLE, MD 20705 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $305 | $3K | 2.79% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOC LLC | 4740 CORRIDOR PL STE B BELTSVILLE, MD 20705 | UNITEDHEALTHCARE INSURANCE COMPANY | $540 | $0 | $540 | 2.35% |
| JOHN D DOTEN Filed as: JOHN D. DOTEN | 6430 ROCKLEDGE DR STE 300 BETHESDA, MD 20817 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | — | $0 | — |
| POTOMAC BASIN GROUP ASSOCIATES LLC | 4740 CORRIDOR PL STE B BELTSVILLE, MD 20705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | — | $0 | — |
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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CAREFIRST BLUE CHOICE | 329 | $2.2M |
| Dental | DOMINION NATIONAL | 371 | $172K |
| Vision | DOMINION NATIONAL | 371 | $172K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 339 | $127K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 339 | $127K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 339 | $127K |
| Prescription drug | CAREFIRST BLUE CHOICE | 329 | $2.1M |
| Other(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.