| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE, 6TH FLOOR NEW YORK, NY 10016 | UNITEDHEALTHCARE INSURANCE COMPANY | $67K | $0 | $67K | 1.01% |
| USI INSURANCE SERVICES LLC3 | 101 WEST MAIN STREET, SUITE 900 WORLD TRADE CENTER NORFOLK, VA 21864 | UNITEDHEALTHCARE INSURANCE COMPANY | $52K | $0 | $52K | 0.79% |
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD, SUITE 120 EXECUTIVE PLAZA III HUNT VALLEY, MD 21031 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | $2K | $192 | $3K | 2.19% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INS. GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | $560 | $3 | $563 | 0.47% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS | PO BOX 310502 DES MOINES, IA 50331 | METLIFE LEGAL PLANS | $2K | $0 | $2K | 10.00% |
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 | 661 | 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) | 661 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.7M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,526 | $6.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,526 | — |
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.