| 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 | $16K | — | $16K | 11.48% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 772 LITITZ PIKE LITITZ, PA 17543 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | — | $12K | 8.52% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 5.87% |
| AP BENEFIT ADVISORS, LLC3 | 145 W. OSTEND ST. STE 200 BALTIMORE, MD 21230 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $336 | $6K | 7.40% |
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS, LLC DBA EMPLOY | 145 W. OSTEND ST. SUITE 200 BALTIMORE, MD 21230 | FIDELITY SECURITY LIFE INSURANCE | $89 | — | $89 | 0.89% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 | 145 W. OSTEND ST. 2ND FLOOR BALTIMORE, MD 21230 | FIDELITY SECURITY LIFE INSURANCE | -$6 | — | -$6 | -0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS EIN 35-1846036 NONE | Plan Administrator; Claims processing; Other services Service code 12 | — | $133K |
| EMPLOYEE ONE BENEFIT SOLUTIONS EIN 20-8205286 NONE | Consulting (general); Insurance agents and brokers Service code 16 | — | $77K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | — | $22K |
| EYEMED VISION CARE EIN 31-1656473 NONE | Other services; Claims processing Service code 12 | — | $11K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Claims processing; Other services Service code 12 | — | $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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $84K |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 161 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $142K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $142K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $142K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 172 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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.