| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON S BELL3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $2K | $584 | $3K | 5.18% |
| R TODD GRANDY3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $2K | $584 | $3K | 5.18% |
| DAVID WAYNE ZIEGLER3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $464 | $166 | $630 | 1.12% |
| SCOTT IODICE ASSC LLC3 | 111 S CALVERT ST STE 2500 BALTIMORE, MD 21202 | NORTHWESTERN MUTUAL | $464 | $56 | $520 | 0.93% |
| R TODD GRANDY3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $526 | $224 | $750 | 7.88% |
| JASON S BELL3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $526 | $224 | $750 | 7.88% |
| DAVID WAYNE ZIEGLER3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $105 | $38 | $143 | 1.50% |
| SCOTT IODICE ASSC LLC3 | 111 S CALVERT ST STE 2500 BALTIMORE, MD 21202 | NORTHWESTERN MUTUAL | $105 | $13 | $118 | 1.24% |
| R TODD GRANDY3 | 307 INTERNATIONAL CIRCLE SUITE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $523 | $132 | $655 | 6.93% |
| JASON S BELL3 | 307 INTERNATIONAL CIR STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $523 | $132 | $655 | 6.93% |
| DAVID WAYNE ZIEGLER3 | 307 INTERNATIONAL CIE STE 310 HUNT VALLEY, MD 21030 | NORTHWESTERN MUTUAL | $105 | $38 | $143 | 1.51% |
| SCOTT IODICE ASSC LLC3 | 111 S CALVERT ST STE 2500 BALTIMORE, MD 21202 | NORTHWESTERN MUTUAL | $105 | $13 | $118 | 1.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ENGLE HAMBRIGHT & DAVIES, INC. EIN 23-0558310 BROKER | Insurance agents and brokers Service code 22 | — | $17K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| HIGHMARK BLUE SHIELD (CENTRAL) EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $10K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 74 | 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) | 74 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | NORTHWESTERN MUTUAL | 74 | $10K |
| Short-term disability | NORTHWESTERN MUTUAL | 44 | $9K |
| Long-term disability | NORTHWESTERN MUTUAL | 59 | $56K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 39 | $235K |
| Other | WELLSPAN EMPLOYEE ASSISTANCE PROGRAM | 63 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 74 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.