| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 | 1 PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $58K | $63K | 5.10% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $26K | $26K | 2.13% |
| EBSME LLC3 Filed as: EBSME, LLC | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 0.11% |
| TRIBRIDGE PARTNERS LLC3 | ONE EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 13.69% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOCIATES INSURANCE GROU | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $769 | $3K | 9.18% |
| EBSME LLC3 Filed as: EBSME, LLC | 4704 DEINVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $719 | $1K | $2K | 6.93% |
| TRIBRIDGE PARTNERS LLC3 | EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.88% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSURANCE GROU | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $483 | $2K | 8.21% |
| EBSME LLC3 Filed as: EBSME, LLC | 4704 DEINVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.56% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | ONE EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $552 | — | $552 | 5.06% |
| EBSME LLC3 Filed as: EBSME, LLC | PO BOX 120 MOUNT AIRY, MD 21771 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $473 | — | $473 | 4.34% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES/KMS | 1 KELLY WAY SPARKS, MD 21152 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $237 | — | $237 | 2.17% |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 136 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 136 | $1.2M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 187 | $1.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $31K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $30K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
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.