| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | HCC LIFE INSURANCE COMPANY | $37K | $6K | $43K | 17.55% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $709 | $4K | 17.15% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | $639 | $2K | 13.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK - KELLY EIN 54-1637426 NONE | Insurance agents and brokers; Insurance services; Claims processing Service code 12 | — | $74K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Contract Administrator Service code 12 | — | $7K |
| UNITED OF OMAHA - KELLY EIN 47-0322111 NONE | Contract Administrator; Insurance agents and brokers; Claims processing Service code 12 | — | $7K |
| FOREST T. JONES - KELLY EIN 43-1451185 NONE | Contract Administrator; Claims processing; Insurance agents and brokers Service code 12 | — | $2K |
| HEALTH ADVOCATE - KELLY EIN 23-3080019 NONE | Contract Administrator; Insurance agents and brokers; Insurance services Service code 13 | — | $0 |
| KELLY & ASSOCIATES - UNITED ADMIN EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
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 | 139 | 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) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MUTUAL OF OMAHA LIFE INSURANCE COMPANY | 139 | $18K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $20K |
| Other(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 139 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.