| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND LLC | 3601 MACCORKLE AVE. SE STE 50 CHARLESTON, WV 25304 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $52K | $3K | $55K | 4.09% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GRP INC | 1 KELLY WAY SPARKS, MD 21152 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $19K | $24 | $19K | 1.43% |
| BLACK, JAY, E3 Filed as: BLACK,JAY | 1400 MIDHURST CT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 10.59% |
| BENT, ANN MARIE,3 Filed as: BENT,ANN MARIE | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 8.33% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND, LLC | 11311 MCCORMICK RD STE 500 HUNT VALLEY, MD 21031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 7.61% |
| COMMERCIAL INSURANCE MANAGERS3 Filed as: COMMERCIAL INSURANCE MANAGERS INC | 8600 FOUNDRY ST BOX 2030 SAVAGE, MD 20763 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $849 | — | $849 | 0.72% |
| VIDAL-AWBREY, SONIA, A3 Filed as: VIDAL-AWBREY,SONIA | 2665 PROSPERITY AVE APT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $600 | — | $600 | 0.51% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC INSURANCE GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | $2K | $6K | 7.87% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK RD STE 500 HUNT VALLEY, MD 21031 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 5.80% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND, LLC | 11311 MCCORMICK RD STE 500 HUNT VALLEY, MD 21031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $305 | $6K | 9.23% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INSURANCE G | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 5.00% |
| BLACK, JAY, E3 Filed as: BLACK,JAY | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.50% |
| BENT, ANN MARIE,3 Filed as: BENT,ANN MARIE | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.42% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND, LLC | 11311 MCCORMICK RD STE 500 HUNT VALLEY, MD 21031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 3.18% |
| COMMERCIAL INSURANCE MANAGERS3 Filed as: COMMERCIAL INSURANCE MANAGERS INC | 8600 FOUNDRY ST BOX 2030 SAVAGE, MD 20763 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $147 | — | $147 | 0.31% |
| VIDAL-AWBREY, SONIA, A3 Filed as: VIDAL-AWBREY,SONIA | 2665 PROSPERITY AVE APT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $103 | — | $103 | 0.22% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND, LLC | 11311 MCCORMICK RD STE 500 HUNT VALLEY, MD 21031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $25 | $1K | 15.37% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INSURANCE G | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $337 | $337 | 5.00% |
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 | 233 | 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) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 130 | $1.4M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 153 | $79K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 153 | $79K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 370 | $195K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 370 | $118K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 232 | $70K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 232 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.