| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE | 15825 SHADY GROVE RD SUITE 170 GERMANTOWN, MD 20850 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE | 15825 SHADY GROVE RD SUITE 170 GERMANTOWN, MD 20850 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $856 | — | $856 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE LOOMIS COMPANY EIN 23-2238132 | Contract Administrator Service code 13 | — | $82K |
| CIGNA HEALTH & LIFE INSURANCE COMP EIN 59-1031071 | Contract Administrator Service code 13 | — | $1K |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $9K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $9K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.