| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ALTANTIC | $16K | — | $16K | 5.21% |
| EBCA5 Filed as: EBCA GENERAL AGENCY- BDG TPA | 1410 SPRING HILL RD SUITE 150 MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ALTANTIC | $4K | — | $4K | 1.22% |
| JOSEPH A APPELBAUM3 Filed as: JOSEPH AVRUM APPELBAUM | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN INC - CA | $12K | $1K | $14K | 5.86% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $33K | $3K | $37K | 18.02% |
| ENROLLEASE5 | 660 YORK STREET SUITE 102 SAN FRANCISCO, CA 94110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.67% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE & BENEFIT SERVS | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | $5K | $40K | 25.80% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE INC. | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | LEGAL RESOURCES | $570 | — | $570 | 6.48% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE INC. | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $672 | — | $672 | 17.32% |
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 | 194 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ALTANTIC | 64 | $696K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $203K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $203K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $203K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $203K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $203K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ALTANTIC | 64 | $696K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $212K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.