| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. CAREFIRST BLUECHOICE, INC | $25K | $12K | $38K | 4.11% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 9.91% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | CIGNA GROUP INSURANCE | $2K | $529 | $3K | 8.76% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | CIGNA GROUP INSURANCE | $2K | $233 | $2K | 16.60% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | VISION SERVICE PLAN | $785 | — | $785 | 7.13% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INSUANCE GROUP | 1 KELLY WAY SPARKS, MD 21152 | CIGNA GROUP INSURANCE | $1K | $176 | $1K | 12.74% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | CIGNA GROUP INSURANCE | $141 | $22 | $163 | 12.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH ADVOCATE EIN 23-3080019 NONE | Contract Administrator Service code 13 | — | $0 |
| KELLY & ASSOC. CIGNA EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| KELLY & ASSOICATES - VSP ADM EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| TASC - KELLY & ASSOCIATES EIN 39-1561025 NONE | Insurance services; Contract Administrator Service code 13 | — | $0 |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. CAREFIRST BLUECHOICE, INC | 132 | $916K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 112 | $39K |
| Vision | VISION SERVICE PLAN | 81 | $11K |
| Life insurance | CIGNA GROUP INSURANCE | 146 | $10K |
| Short-term disability | CIGNA GROUP INSURANCE | 146 | $30K |
| Long-term disability | CIGNA GROUP INSURANCE | 146 | $14K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. CAREFIRST BLUECHOICE, INC | 132 | $916K |
| Other | CIGNA GROUP INSURANCE | 146 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.