| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 15200 OMEGA DR SUITE 100 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.73% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 15200 OMEGA DR SUITE 100 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE OF AMERICA | $854 | — | $854 | 0.85% |
| AP BENEFIT ADVISORS, LLC3 | 15200 OMEGA DR SUITE 100 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $574 | — | $574 | 0.82% |
| EMPLOYEE NAVIGATOR, LLC3 Filed as: EMPLOYEE NAVIGATOR LLC | 7979 OLD GEROGETOWN RD STE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $175 | — | $175 | 0.46% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR SUITE 200 HUNT VALLEY, MD 210301827 | VISION SERVICE PLAN | $1 | — | $1 | 0.00% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE SUITE 200 HUNT VALLEY, MD 21030 | ARAG INSURANCE COMPANY | $109 | — | $109 | 0.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $151K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $87K |
| HEALTH ADVOCATE SOLUTIONS, INC. EIN 23-3080019 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $12K |
| INSPIRA FINANCIAL TPA | Contract Administrator; Claims processing Service code 12 | 2001 SPRING RD # 700 OAK BROOK, IL 60523 | $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 | 420 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 260 | $38K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 340 | $149K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 340 | $70K |
| Long-term disability | UNUM LIFE INSURANCE OF AMERICA | 420 | $101K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 340 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.