| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | DELTA DENTAL OF PENNSYLVANIA | $8K | — | $8K | 8.00% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 7556 TEAGUE ROAD STE 300 HANOVER, MD 21076 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 6.84% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 212301827 | VISION SERVICE PLAN | $1K | — | $1K | 6.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMINISTRATORS EIN 52-1187907 NONE | Other services; Claims processing; Plan Administrator Service code 12 | 1501 CLINTON ST 7TH FLOOR BALTIMORE, MD 21224 | $102K |
| EMPLOYEE ONE BENEFIT SOLUTION EIN 20-8205286 NONE | Insurance agents and brokers Service code 22 | — | $62K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Contract Administrator; Claims processing; Other services Service code 12 | — | $51K |
| HEALTHSPARQ EIN 35-2486216 NONE | Other services Service code 49 | — | $990 |
| CONIFER VALUE-BASED CARE EIN 52-1964905 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $693 |
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 | 326 | 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) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 319 | $102K |
| Vision | VISION SERVICE PLAN | 135 | $17K |
| Life insurance | STANDARD INSURANCE COMPANY | 326 | $65K |
| Short-term disability | STANDARD INSURANCE COMPANY | 326 | $65K |
| Long-term disability | STANDARD INSURANCE COMPANY | 326 | $65K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO. | 202 | $327K |
| Other | STANDARD INSURANCE COMPANY | 326 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.