| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | HCC LIFE INSURANCE COMPANY | $98K | — | $98K | 17.07% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $17K | $28K | 9.27% |
| KELLY & ASSOCIATES INSURANCE GROUP5 | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $11K | $22K | 10.50% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE DBA GHC ASSOCIATE | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | — | $10K | 13.50% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE DBA GHC ASSOCIATE | 200 GALLERIA PARKWAY, STE. 1950 ATLANTA, GA 30339 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $4K | $10K | 16.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY BENEFIT STRATEGIES | 1 KELLY WAY SPARKS, MD 21152 | EYEMED VISION CARE | $3K | — | $3K | 11.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS, INC EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $129K |
| AETNA - PPO EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $43K |
| MULTIPLAN, INC. EIN 13-3068979 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $13K |
| DISCOVERY BENEFITS NONE | Claims processing Service code 12 | 4321 20TH AVE. S FARGO, ND 58103 | $8K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Claims processing; Other services Service code 12 | — | $8K |
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 | 250 | 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) | 250 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 221 | $572K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 377 | $208K |
| Vision | EYEMED VISION CARE | 290 | $26K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 250 | $141K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $300K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $300K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 250 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.