| 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 | $7K | $0 | $7K | 10.44% |
| EBSME LLC3 | 4704 DE INVIERNO WAY PO BOX 120 MOUNT AIRY, MD 217710120 | PRINCIPAL LIFE INSURANCE COMPANY | $175 | $0 | $175 | 0.28% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $866 | $3K | 20.13% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $110 | $46 | $156 | 1.06% |
| PROSENTIAL BENEFITS LLC3 | 100 STONEWALL BLVD STE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $42 | $42 | 0.29% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $77 | $1K | 10.09% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $65 | $41 | $106 | 0.81% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS | 100 STONEWALL BLVD STE 1 WRENTHAM, MA 02093 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $24 | $24 | 0.18% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $525 | $2K | 19.83% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $71 | $28 | $99 | 1.05% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS | 40 TIOGA WAY STE 230 MARBLEHEAD, ME 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $24 | $24 | 0.25% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | 1 E PRATT ST STE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $668 | $391 | $1K | 15.06% |
| EBSNE LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $35 | $21 | $56 | 0.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMIN | Claims processing Service code 12 | 1501 S. CLINTON ST 7TH FLOOR BALTIMORE, MD 21224 | $30K |
| TRIBRIDGE PARTNERS BROKER | Insurance agents and brokers Service code 22 | 1 E PRATT ST SUITE 902 BALTIMORE, MD 21202 | $25K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| 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 | 88 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $63K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $63K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $15K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 69 | $240K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.