| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BLVE STE 210 ROCKVILLE, MD 208506536 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | — | $16K | 1.43% |
| ADAM H MILLER3 Filed as: ADAM HOWARD MILLER | 23 ROLLING ACRES WAY REISTERSTOWN, MD 211365648 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 0.52% |
| STRATEBEN INC3 | 3 BETHESDA METRO CTR STE 700 BETHESDA, MD 208146300 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 0.52% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE DBA GHC ASSOCIATE | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | $7K | $18K | 16.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 702 KING FARM BLVD STE 210 ROCKVILLE, MD 208506536 | DELTA DENTAL OF PENNSYLVANIA | $5K | — | $5K | 4.84% |
| ADAM H MILLER3 | 23 ROLLING ACRES WAY REISTERSTOWN, MD 211365648 | DELTA DENTAL OF PENNSYLVANIA | $3K | — | $3K | 2.58% |
| STRATEBEN INC3 Filed as: STRATEBEN | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 208146300 | DELTA DENTAL OF PENNSYLVANIA | $3K | — | $3K | 2.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | GUARDIAN INSURANCE COMPANY | $374 | $264 | $638 | 4.18% |
| STRATEBEN INC3 Filed as: STRATEBEN | 3 BETHESDA METRO CENTER FL 17 BETHESDA, MD 20814 | GUARDIAN INSURANCE COMPANY | $195 | — | $195 | 1.28% |
| ADAM H MILLER3 | 23 ROLLING ACRES WAY REISTERTOWN, MD 21136 | GUARDIAN INSURANCE COMPANY | $195 | — | $195 | 1.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 15800 CRABBS BRCH WAY SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 16.75% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $324 | — | $324 | 2.16% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $323 | — | $323 | 2.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $272 | $272 | 1.81% |
| ADAM H MILLER3 Filed as: ADAM HOWARD MILLER | 23 ROLLING ACRES WAY REISTERSTOWN, MD 21136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38 | — | $38 | 0.25% |
| JOHN H SIMMONDS3 Filed as: JOHN HARDING SIMMONDS | 3 BETHESDA METRO CENTER SUITE 700 BETHESDA, MD 20814 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38 | — | $38 | 0.25% |
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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 219 | $1.2M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 319 | $103K |
| Vision | GUARDIAN INSURANCE COMPANY | 123 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $111K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $111K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $111K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.