| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ERIC M SILVERMAN3 Filed as: ERIC M. SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | MUTUAL OF OMAHA INSURANCE COMPANY | $29K | $1K | $30K | 17.88% |
| NATIONAL BENEFIT PARTNER WEST LLC3 Filed as: NATIONAL BENEFIT PARTNER WEST, LLC | 99 WOOD AVENUE SOUTH, SUITE 501 ISELIN, NJ 08830 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $3K | $3K | 2.00% |
| DAVID J MCCLELLAN3 Filed as: DAVID MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | $0 | $4K | 20.01% |
| MEGAN R SILVERMAN3 Filed as: MEGAN R. SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $3K | $0 | $3K | 15.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID J. MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $729 | $0 | $729 | 3.56% |
| MEGAN R SILVERMAN3 Filed as: MEGAN R. SILVERMAN | 1423 MARTIN MEADOWS DRIVE FALLSTON, MD 21047 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 16.23% |
| DAVID J MCCLELLAN3 Filed as: DAVID J. MCCLELLAN | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | $745 | $0 | $745 | 5.00% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | MUTUAL OF OMAHA INSURANCE COMPANY | 95 | $167K |
| Vision | MUTUAL OF OMAHA INSURANCE COMPANY | 95 | $167K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY OF AMERICA | 96 | $15K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 95 | $167K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 95 | $167K |
| Other(5 contracts, 5 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 120 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.