| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAWRENCE ULVILA3 | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 2.52% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | DELTA DENTAL OF PENNSYLVANIA | $578 | $0 | $578 | 0.48% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $1K | $9K | 13.06% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $633 | $0 | $633 | 0.96% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD STE 140 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $968 | $8K | 15.93% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $519 | $0 | $519 | 1.07% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $904 | $6K | 13.06% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $429 | $0 | $429 | 0.96% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $665 | $4K | 13.07% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 170 JENNIFER RD STE 130 ANNAPOLIS, MD 21401 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $313 | $0 | $313 | 0.96% |
| ISI OF MD LLC3 | 170 JENNIFER ROAD STE 130 ANNAPOLIS, MD 21401 | EYEMED VISION CARE | $1K | $0 | $1K | 6.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CMFI (CAREFIRST) EIN 52-1358219 ADMIN | Claims processing Service code 12 | — | $87K |
| ISI OF MARYLAND, LLC BROKER | Insurance agents and brokers Service code 22 | 170 JENNIFER RD SUITE 130 ANNAPOLIS, MD 21401 | $66K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $31K |
| EPIPHANY RX, LLC ADMIN | Claims processing Service code 12 | 7271 NOLENSVILLE RD, SUITE 200 NOLENSVILLE, TN 37135 | $23K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $11K |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 399 | $120K |
| Vision | EYEMED VISION CARE | 351 | $22K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $33K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $45K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $66K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 172 | $566K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 399 | — |
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.