| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS LLC DBA | 20 SOUTH KING STREET LEESBURG, VA 20175 | HARVARD PILGRIM HEALTH CARE OF NE INC-MA | $34K | — | $34K | 3.33% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 3.63% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD HARRISON & THOMAS LLC D/B/ | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | METROPOLITAN LIFE INSURANCE COMPANY | $499 | — | $499 | 1.21% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $400 | $400 | 5.00% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $729 | — | $729 | 15.00% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $243 | $243 | 5.00% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $596 | — | $596 | 15.01% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $199 | $199 | 5.01% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $568 | — | $568 | 15.00% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $189 | $189 | 4.99% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $358 | — | $358 | 14.99% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $119 | $119 | 4.98% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $279 | — | $279 | 14.99% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $93 | $93 | 5.00% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $123 | — | $123 | 15.00% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $41 | $41 | 5.00% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $61 | — | $61 | 15.14% |
| GROUP INSURANCE SERVICES INC3 | GA PURPOSES ONLY 1607 NORTH AURORA ROAD SUITE 201 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $20 | $20 | 4.96% |
No Schedule C service providers reported on this filing.
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE OF NE INC-MA | 207 | $1.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 471 | $41K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 471 | $41K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $1K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $7K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $6K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.