| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE ONE BENEFIT SOLUTIONS LLC | 921 E. FORT AVE. STE 325 BALTIMORE, MD 21230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE ONE BENEFIT SOLUTIONS LLC | 921 E. FORT AVE. STE 325 BALTIMORE, MD 21230 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $362 | — | $362 | 1.42% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 921 E. FORT AVE STE 325 BALTIMORE, MD 21230 | MONUMENTAL LIFE INSURANCE COMPANY | $62 | — | $62 | 6.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $41K |
| EMPLOYEE ONE BENEFIT SOLUTIONS EIN 20-8205286 NONE | Consulting (general); Insurance agents and brokers Service code 16 | 921 E. FORT AVE. STE 325 BALTIMORE, MD 21230 | $15K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | — | $7K |
| MULTIPLAN, INC. EIN 13-3068919 NONE | Plan Administrator; Claims processing; Other services Service code 12 | — | $2K |
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 | 204 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MONUMENTAL LIFE INSURANCE COMPANY | 9 | $924 |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 169 | $25K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 169 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $34K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $34K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $34K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 204 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.