| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN RD ROCKVILLE, MD 208522860 | RELIASTAR LIFE INSURANCE COMPANY | — | $1.0M | $1.0M | 19.94% |
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN RD ROCKVILLE, MD 208522860 | RELIASTAR LIFE INSURANCE COMPANY | — | $980K | $980K | 20.00% |
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN RD ROCKVILLE, MD 208522860 | ARAG INSURANCE COMPANY | — | $18K | $18K | 24.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAMBA BENEFIT PLAN EIN 52-1074154 EMPLOYEES | Employee (plan); Direct payment from the plan Service code 30 | — | $2.0M |
| CHANGE HEALTHCARE EIN 45-3637794 NONE | Direct payment from the plan; Participant communication Service code 38 | — | $489K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $378K |
| COUNTERPOINT EIN 51-0300805 NONE | Direct payment from the plan; Consulting (general); Other services Service code 16 | — | $274K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $254K |
| HBP, INC. EIN 04-3725251 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $192K |
| EYEMED VISION CARE EIN 86-0773195 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $104K |
| VW BROWN INSURANCE SERVICES LLC EIN 26-0274369 NONE | Other commissions; Insurance agents and brokers Service code 22 | — | $93K |
| BOND BEEBE, P.C. EIN 52-1044197 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $63K |
| WILLIAM P. O'HANLON PRESIDENT, SAMBA BOD | Consulting (general); Direct payment from the plan Service code 16 | 2496 DURHAM PLACE JEFFERSON, VA 22724 | $46K |
| ERMER LAW GROUP EIN 26-1616418 D ERMER, SAMBA BOD | Legal; Direct payment from the plan Service code 29 | — | $33K |
| AON CONSULTING, INC EIN 22-2232264 NONE | Actuarial; Direct payment from the plan; Consulting (general); Accounting (including auditing) Service code 10 | — | $29K |
| CIGNA EIN 59-1031071 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $26K |
| HOUSE OF PRINTING EIN 52-0942907 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $16K |
| NIEHUS ACTUARIAL SERVICES, INC EIN 36-4420442 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
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 | 106,454 | 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) | 106,454 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 8,862 | $3.3M |
| Life insurance(2 contracts) | RELIASTAR LIFE INSURANCE COMPANY | 78,623 | $10.2M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 28,404 | $5.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 78,623 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.