| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | SYMETRA LIFE INSURANCE COMPANY | $138K | $26K | $164K | 17.85% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | THE HARTFORD | $76K | $73K | $149K | 20.17% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KENSINGTON, RI 02852 | TRANSAMERICA INSURANCE COMPANY MEDICARE SUPPLEMENT | $20K | — | $20K | 10.79% |
| DIETRICH & ASSOCIATES0 | 1000 GERMANTOWN PIKE SUITE K-1 PLYMOUTH MEETING, PA 19462 | TRANSAMERICA INSURANCE COMPANY MEDICARE SUPPLEMENT | $11K | — | $11K | 6.10% |
| WEBB TPA0 | 8500 FREEPORT PKWY IRVING, TX 75063 | TRANSAMERICA INSURANCE COMPANY MEDICARE SUPPLEMENT | $9K | — | $9K | 5.07% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | STERLING LIFE | $14K | — | $14K | 11.69% |
| DIETRICH & ASSOCIATES0 | 1000 GERMANTOWN PIKE SUITE K-1 PLYMOUTH MEETING, PA 19462 | STERLING LIFE | $1K | — | $1K | 1.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS FLORIDA - KELLY EIN 59-2015694 NONE | Insurance services; Insurance agents and brokers; Claims processing; Contract Administrator Service code 12 | — | $925K |
| DELTA DENTAL - KELLY EIN 23-1667011 NONE | Claims processing; Insurance services; Contract Administrator Service code 12 | — | $75K |
| HARTFORD - KELLY EIN 06-0838648 NONE | Claims processing; Insurance services; Contract Administrator Service code 12 | — | $40K |
| VSP - KELLY EIN 23-7089668 NONE | Claims processing; Insurance agents and brokers; Contract Administrator Service code 12 | — | $26K |
| HEALTH ADVOCATE EIN 23-3080019 NONE | Insurance services; Insurance agents and brokers; Contract Administrator Service code 13 | — | $0 |
| KELLY & ASSOCIATES - COBRA FEES EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| KELLY & ASSOCIATES - HARTFORD ADMIN EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| TOTAL ADMINISTRATIVE SERVICES - KEL EIN 23-3080019 NONE | Insurance services; Contract Administrator Service code 13 | — | $0 |
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 | 1,280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE COMPANY MEDICARE SUPPLEMENT | 113 | $187K |
| Life insurance | THE HARTFORD | 1,280 | $737K |
| Long-term disability | THE HARTFORD | 1,280 | $737K |
| Prescription drug | STERLING LIFE | 111 | $122K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,280 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,280 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.