| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MID ATLANTIC BENEFITS GROUP LLC3 Filed as: MID ATLANTIC BENEFITS GROUP LLC DBA | 203 MARKET STREET SUITE 201 HAVRE DE GRACE, MD 21078 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $84 | $2K | 7.05% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720-B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $617 | — | $617 | 2.62% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $199 | — | $199 | 0.84% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $631 | $3K | 19.34% |
| MID ATLANTIC BENEFITS GROUP LLC3 Filed as: MID ATLANTIC BENEFITS GROUP LLC DBA | 203 MARKET STREET SUITE 201 HAVRE DE GRACE, MD 21078 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $423 | $30 | $453 | 3.37% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720-B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $170 | — | $170 | 1.27% |
| EMPLOYEE FAMILY PROTECTION INC3 | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $61 | — | $61 | 0.45% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720A ROCKLEDGE DRIVE #400 BETHESDA, MD 20817 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $796 | — | $796 | 10.94% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP, LLC | 6720B ROCKLEDGE DRIVE SUITE 400 BETHESDA, MD 20817 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $596 | $168 | $764 | 19.22% |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 125 | $7K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 78 | $42K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 55 | $24K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 78 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.