| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $3K | $6K | 9.45% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 15.28% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $777 | $2K | 15.14% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $715 | $2K | 15.47% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND | 540 FORT EVANS RD., STE. 301 LEESBURG, VA 20176 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $779 | $433 | $1K | 15.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HILB GROUP OF MARYLAND EIN 47-4324398 PRODUCER | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $65K |
| ULTRABENEFITS, INC. EIN 04-3525752 BENEFITS ADMINISTRATOR | Claims processing; Insurance agents and brokers; Contract Administrator Service code 12 | — | $21K |
| CIGNA EIN 59-1031071 TPA | Claims processing; Contract Administrator; Insurance services Service code 12 | — | $11K |
| AMERICAN HEALTH HOLDINGS EIN 31-1368946 UR/ CASE MANAGEMENT | Consulting (general); Claims processing; Contract Administrator Service code 12 | — | $4K |
| RIGHTWAY (CD1) EIN 82-0865206 CONCIERGE | Contract Administrator; Consulting (general) Service code 13 | — | $2K |
| TELEDOC EIN 20-1020949 NETWORK | Insurance services; Other insurance fees and expenses; Insurance agents and brokers Service code 22 | — | $1K |
| PHIA GROUP EIN 04-3504115 FIDUCIARY | Named fiduciary Service code 31 | — | $743 |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $60K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $60K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $15K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 51 | $288K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.