| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD CHICOSKI III Filed as: EDWARD J. CHICOSKI | 529 MAIN STREET NEW HARTFORD, CT 06057 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CARDAY ASSOCIATES, INC. EIN 53-0257019 | Contract Administrator Service code 13 | 7130 COLUMBIA GATEWAY DR COLUMBIA, MD 21046 | $380K |
| ALTON & BIRD LLP EIN 58-0137615 | Legal Service code 29 | 950F STREET N.W. WASHINGTON, DC 20004 | $151K |
| TOAL,GRIFFITH AND RAGULA, LLC EIN 20-0274631 | Accounting (including auditing) Service code 10 | 130 ADMIRAL COCHRANE DR ANNAPOLIS, MD 21401 | $31K |
| THE SEGAL COMPANY EIN 13-1835864 | Actuarial Service code 11 | 333 W 34TH STREET NEW YORK, NY 10001 | $15K |
| ULICO CASUALTY GROUP EIN 52-2197710 | Insurance agents and brokers Service code 22 | 333 WEST 34TH STREET 2ND NEW YORK, NY 10001 | $6K |
| 3D ASSET MANAGEMENT EIN 20-3725583 | Investment management Service code 28 | 100 CONSTITUTION PLAZA HARTFORD, CT 06103 | $6K |
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 | 1,368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 39 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,773 | $7.1M |
| Dental | GROUP DENTAL SERVICES OF MARYLAND, INC. | 2,663 | $93K |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,773 | $7.1M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,773 | $7.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,663 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.