| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | 5280 CORPORATE DR FREDERICK, MD 217038502 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.49% |
| EBSME LLC3 | 4704 DE INVIERNO WAY PO BOX 120 MOUNT AIRY, MD 217710120 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.66% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $677 | $3K | 19.25% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $102 | $21 | $123 | 0.91% |
| PROSENTIAL BENEFITS LLC3 | 100 STONEWALL BLVD STE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $101 | $101 | 0.75% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $623 | $2K | 14.62% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS | 100 STONEWALL BLVD STE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $104 | $104 | 0.85% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $61 | $19 | $80 | 0.66% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $653 | $391 | $1K | 15.18% |
| PROSENTIAL BENEFITS LLC3 | 100 STONEWALL BLVD STE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $67 | $67 | 0.97% |
| EBSNE LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $34 | $12 | $46 | 0.67% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $372 | $1K | — |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $55 | $11 | $66 | — |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS | 40 TIOGA WAY STE 230 MARBLEHEAD, ME 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $62 | $62 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMIN | Claims processing Service code 12 | 1501 S. CLINTON ST 7TH FLOOR BALTIMORE, MD 21224 | $32K |
| TRIBRIDGE PARTNERS BROKER | Insurance agents and brokers Service code 22 | 1 E PRATT ST SUITE 902 BALTIMORE, MD 21202 | $22K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
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 | 71 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 72 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 157 | $65K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 157 | $65K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 87 | $12K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 87 | $14K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 66 | $182K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 87 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
No prospect flags tripped on this filing.