| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 MID ATLANTIC 520 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $732 | $54K | $55K | 4.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $27K | $27K | 1.97% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INSURANCE G | — | UNITED CONCORDIA INSURANCE COMPANY | $7K | $4K | $11K | 13.98% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSU | 1 KELLY WAY SPARKS, MD 21152 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 12.57% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LL | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $764 | $764 | 2.07% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSU | 1 KELLY WAY SPARKS, MD 21152 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $5K | 16.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LL | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $630 | $630 | 2.22% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSU | 1 KELLY WAY SPARKS, MD 21152 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 13.80% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LL | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $536 | $536 | 2.23% |
| MARY THERESA FISHER3 | 29 OWENS LANDING COURT APARTMENT C PERRYVILLE, MD 21903 | PRE-PAID LEGAL SERVICES INC DBA LEAGALSHIELD | $595 | — | $595 | 6.61% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSU | 1 KELLY WAY SPARKS, MD 21152 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $821 | $347 | $1K | 16.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LL | PO BOX 61007 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 2.20% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 96 | $1.4M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 111 | $80K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 96 | $1.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $37K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $28K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.