| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DRIVE SUITE 200 CAMDEN, NJ 08103 | CAREFIRST BLUECHOICE, INC. | — | $26K | $26K | 0.73% |
| MATHER & STROHL ADMIN SVC INC5 Filed as: MATHER & STROHL ADMINISTRATIVE | SERVICES 12404 PARK CENTRAL DRIVE SUITE 400 DALLAS, TX 75251 | CAREFIRST BLUECHOICE, INC. | — | $6K | $6K | 0.17% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $51K | $16K | $67K | 13.53% |
| CORPORATE SYNERGIES GROUP LLC5 | 2 AQUARIUM DR STE 200 CAMDEN, NJ 08103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $836 | $836 | 0.17% |
| BLACK, JAY, E3 Filed as: BLACK, JAY | 1400 MIDHURST CT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 1.30% |
| VIDAL-AWBREY, SONIA, A3 Filed as: VIDAL-AWBREY, SONIA | APT 113 2665 PROSPERITY AVE FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.65% |
| BENT, ANN MARIE,3 Filed as: BENT, ANN MARIE | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.65% |
| FUNK, CATHLENE3 | 12 COLONIAL OAKS COURT PHOENIX, MD 21131 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 3.55% |
| CORPORATE SYNERGIES GROUP LLC3 | 780 W. GRANADA BOULEVARD ORMOND BEACH, FL 32174 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.71% |
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 | 407 | 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) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 541 | $3.5M |
| Dental | CAREFIRST BLUECHOICE, INC. | 541 | $3.5M |
| Vision | CAREFIRST BLUECHOICE, INC. | 541 | $3.5M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 407 | $504K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 407 | $497K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 407 | $497K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 541 | $3.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 407 | $497K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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.