| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $147 | $6K | 8.59% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 217710120 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.09% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 14.14% |
| TRIBRIDGE PARTNERS LLC3 | 1 E PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $687 | $687 | 4.15% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $123 | $48 | $171 | 1.03% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.50% |
| TRIBRIDGE PARTNERS LLC3 | 1 E PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $612 | $612 | 4.17% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $73 | $43 | $116 | 0.79% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 14.25% |
| TRIBRIDGE PARTNERS LLC3 | 1 E PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $492 | $492 | 3.82% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $97 | $35 | $132 | 1.02% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DRIVE SUITE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $569 | $0 | $569 | 9.49% |
| TRIBRIDGE PARTNERS LLC3 | 1 E PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $387 | $387 | 6.46% |
| EBSNE LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 217715030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $30 | $27 | $57 | 0.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMIN | Claims processing Service code 12 | 1501 S. CLINTON ST 7TH FLOOR BALTIMORE, MD 21224 | $38K |
| TRIBRIDGE PARTNERS BROKER | Insurance agents and brokers Service code 22 | 1 E PRATT ST SUITE 902 BALTIMORE, MD 21202 | $23K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| 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 | 59 | 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) | 59 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 182 | $69K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 182 | $69K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $17K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 59 | $296K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.