| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE ONE BENEFIT SOLUTIONS LLC | 921 E. FORT AVE BALTIMORE, MD 21230 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $30K | $4K | $34K | 22.64% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE ONE BENEFIT SOLUTIONS LLC | 921 E. FORT AVE STE 325 BALTIMORE, MD 21230 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 7.00% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | FIDELITY SECURITY LIFE INSURANCE | $1K | — | $1K | 9.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $151K |
| EMPLOYEE ONE BENEFIT SOLUTIONS EIN 20-8205286 NONE | Insurance agents and brokers; Consulting (general) Service code 16 | — | $89K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | — | $23K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Other services; Claims processing Service code 12 | — | $5K |
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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 120 | $102K |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 173 | $11K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.