| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | HCC LIFE INSURANCE COMPANY | $85K | — | $85K | 16.59% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $14K | $24K | 8.52% |
| KELLY & ASSOCIATES INSURANCE GROUP5 | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $12K | $19K | 8.33% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | — | $18K | $18K | 8.14% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 12.37% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $4K | $10K | 14.64% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY BENEFIT STRATEGIES | 1 KELLY WAY SPARKS, MD 21152 | EYEMED VISION CARE | $4K | — | $4K | 12.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS, INC EIN 35-1846036 NONE | Claims processing; Other services; Plan Administrator Service code 12 | — | $172K |
| AETNA EIN 06-6033492 NONE | Other services; Claims processing Service code 12 | — | $42K |
| MULTIPLAN, INC. EIN 13-3068979 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $32K |
| DISCOVERY BENEFITS NONE | Claims processing Service code 12 | 4321 20TH AVE. S FARGO, ND 58103 | $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 | 259 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 206 | $513K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $226K |
| Vision | EYEMED VISION CARE | 273 | $31K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 259 | $142K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $276K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $276K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 259 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.