| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER & STROHL ADMINISTRATIVE | SERVICES 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | — | $804 | $804 | 0.03% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $49K | $14K | $63K | 13.32% |
| CORPORATE SYNERGIES GROUP LLC5 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $648 | $648 | 0.14% |
| BLACK, JAY, E3 | 1400 MIDHURST CT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 1.51% |
| VIDAL-AWBREY, SONIA, A3 | APT 113 2665 PROSPERITY AVE FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.75% |
| BENT, ANN MARIE,3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.75% |
| BLACK, JAY, E3 | 1400 MIDHURST CT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $678 | — | $678 | 24.94% |
| BENT, ANN MARIE,3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $339 | — | $339 | 12.47% |
| VIDAL-AWBREY, SONIA, A3 | APT 113 2665 PROSPERITY AVE FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $339 | — | $339 | 12.47% |
| FUNK, CATHLENE3 Filed as: FUNK, CATHLENE, | 12 COLONIAL OAKS COURT PHOENIX, MD 21131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26 | — | $26 | 0.96% |
| THOMPSON, DIANA,3 | 12307 MARKBY CT UPPER MARLBORO, MD 20774 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$2K | — | -$2K | -65.39% |
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 | 373 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 394 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 481 | $2.9M |
| Dental | CAREFIRST BLUECHOICE, INC. | 481 | $2.9M |
| Vision | CAREFIRST BLUECHOICE, INC. | 481 | $2.9M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 373 | $481K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 373 | $474K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 373 | $474K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 481 | $2.9M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 373 | $477K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 481 | — |
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.