| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN ROAD ROCKVILLE, MD 20852 | RELIASTAR LIFE INSURANCE COMPANY | — | $1.1M | $1.1M | 19.93% |
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN ROAD ROCKVILLE, MD 20852 | RELIASTAR LIFE INSURANCE COMPANY | — | $1.0M | $1.0M | 20.00% |
| SPECIAL AGENTS MUTUAL BENEFIT ASSOC3 | 11301 OLD GEORGETOWN ROAD ROCKVILLE, MD 20852 | ARAG INSURANCE COMPANY | — | $13K | $13K | 23.09% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAMBA BENEFIT PLAN EIN 52-1074154 EMPLOYEES | Employee (plan); Direct payment from the plan Service code 30 | — | $2.4M |
| CHANGE HEALTHCARE EIN 20-5731067 NONE | Direct payment from the plan; Other services Service code 49 | — | $413K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $390K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $289K |
| COUNTERPOINT SOFTWARE, INC. EIN 51-0300805 NONE | Other services; Consulting (general); Direct payment from the plan Service code 16 | — | $202K |
| VW BROWN INSURANCE SERVICES LLC EIN 26-0274369 NONE | Insurance agents and brokers; Other commissions Service code 22 | — | $94K |
| EYEMED VISION CARE EIN 86-0773195 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $90K |
| ERMER LAW GROUP, PLLC EIN 26-1616418 DAVID ERMER SAMBA SEC'Y | Legal; Direct payment from the plan Service code 29 | — | $75K |
| HBP, INC. EIN 04-3725251 NONE | Direct payment from the plan; Copying and duplicating; Other services Service code 36 | — | $64K |
| WITHUM SMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $50K |
| WILLIAM P. O'HANLON PRESIDENT, SAMBA BOD | Direct payment from the plan; Consulting (general); Other services Service code 16 | 2496 DURHAM PLACE JEFFERSONTON, VA 22724 | $46K |
| CIGNA EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $43K |
| HOUSE OF PRINTING, INC. EIN 52-0942907 NONE | Copying and duplicating; Other services; Direct payment from the plan Service code 36 | — | $31K |
| NIEHUS ACTUARIAL SERVICES, INC. EIN 36-4420442 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
| MITCHELL I. SEROTA & ASSOCIATES INC EIN 36-3266002 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $5K |
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 | 102,272 | 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) | 102,272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 7,588 | $2.8M |
| Life insurance(2 contracts) | RELIASTAR LIFE INSURANCE COMPANY | 78,336 | $10.5M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 26,598 | $5.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 78,336 | — |
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.