| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDWARD CHICOSKI III3 Filed as: EDWARD J. CHICOSKI | 301 ALBANY TURNPIKE CANTON, CT 06019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 10.00% |
| GROUP VISION SERVICES MGMT INC3 | 6700 ALEXANDER GRAHAM BELL DRIVE SUITE 200 COLUMBIA, MD 21046 | DELTA DENTAL - DENTEGRA INSURANCE COMPANY | $4K | — | $4K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CARDAY ASSOCIATES, INC. EIN 53-0257019 | Plan Administrator Service code 14 | 7130 COLUMBIA GATEWAY DR COLUMBIA, MD 21046 | $394K |
| SLEVIN & HART | Legal Service code 29 | 1625 MASSACHUSETTS AVE NW 202-797-8700 WASHINGTON, DC 20036 | $41K |
| ALSTON & BIRD LLP EIN 58-0137615 | Legal Service code 29 | 950 F STREET N.W. WASHINGTON, DC 20004 | $29K |
| MORGAN, LEWIS & BOCKIUS, LLP | Legal Service code 29 | 1111 PENNSYLVANIA AVE, NW WASHINGTON, DC 20004 | $22K |
| TOAL, MURRAY, DAY, & LALOR, LLC EIN 82-2029500 | Accounting (including auditing) Service code 10 | 130 ADMIRAL COCHRANE DR ANNAPOLIS, MD 21401 | $16K |
| THE SEGAL COMPANY EIN 13-1835864 | Actuarial Service code 11 | 333 W 34TH STREET NEW YORK, NY 10001 | $15K |
| SEGAL SELECT INSURANCE SERVICES INC EIN 46-0619194 | Insurance services; Insurance brokerage commissions and fees Service code 23 | 8403 COLESVILLE ROAD SILVER SPRING, MD 20910 | $9K |
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 | 1,098 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,581 | $7.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL - DENTEGRA INSURANCE COMPANY | 3,745 | $94K |
| Vision | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,581 | $6.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,120 | $147K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,581 | $7.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,745 | — |
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.