| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC INS GROUP INC | 1 KELLY WAY SPARKS GLENCOE, MD 21152 | HARTFORD LIFE AND ACCIDENT | $35K | $26K | $61K | 20.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $25K | $2K | $26K | 10.47% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 2.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST,INC | 29727 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4K | — | $4K | 10.74% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES/KMS TPA | 1 KELLY WAY SPARKS, MD 21152 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | — | $1K | 4.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON-POTOMAC, MD | 12505 PARK POTOMAC AVENUE POTOMAC, MD 20854 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $945 | — | $945 | 2.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PLACE CHICAGO, IL 60673 | ARAG INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY & ASSOCIATES | 11300 ROCKVILLE PIKE SUITE 1200 ROCKVILLE, MD 20852 | ARAG INSURANCE COMPANY | — | $1K | $1K | 4.73% |
No Schedule C service providers reported on this filing.
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 | 491 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 523 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 408 | $251K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 534 | $33K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 395 | $299K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 395 | $299K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 395 | $299K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 395 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 534 | — |
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.