| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER & STROHL ADMINISTRATIVE SERV | 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | — | $41K | $41K | 1.30% |
| CORPORATE SYNERGIES GROUP LLC3 Filed as: CORPORATE SYNERGIES GROUOP LLC | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $46K | $18K | $64K | 14.30% |
| CORPORATE SYNERGIES GROUP LLC5 Filed as: CORPORATE SYNERGIES GROUOP LLC | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $482 | $482 | 0.11% |
| BLACK, JAY, E3 | 1400 MIDHURST CT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 1.51% |
| VIDAL-AWBREY, SONIA, A3 | APT 113 2665 PROSPERITY AVE FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.76% |
| BENT, ANN MARIE,3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.76% |
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 509 | $3.1M |
| Dental | CAREFIRST BLUECHOICE, INC. | 509 | $3.1M |
| Vision | CAREFIRST BLUECHOICE, INC. | 509 | $3.1M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $453K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $445K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $445K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 509 | $3.1M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $452K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 509 | — |
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."
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.