| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $72K | $0 | $72K | 3.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 6.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | DOMINION NATIONAL | $8K | $0 | $8K | 9.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $769 | $6K | 17.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 12.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 111 VETERANS BOULEVARD, SUITE 1130 METAIRIE, LA 70005 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 12.37% |
| MATTHEW W EVANS3 Filed as: MATTHEW W. EVANS | 127 BOONE TRAIL SEVERNA PARK, MD 21146 | CONTINENTAL AMERICAN INSURANCE COMPANY | $368 | $0 | $368 | 4.01% |
| DREW SKIBITSKY3 | 11285 DOVEDALE COURT MARRIOTTSVILLE, MD 21104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $69 | $0 | $69 | 0.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | UNITEDHEALTHCARE INSURANCE COMPANY | $391 | $0 | $391 | 9.94% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AND FIN. SVCS | 501 FAIRMOUNT AVENUE, SUITE 400 TOWSON, MD 21286 | UNITEDHEALTHCARE INSURANCE COMPANY | $196 | $0 | $196 | 4.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | $0 | $3 | 0.74% |
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 | 215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 254 | $1.9M |
| Dental | DOMINION NATIONAL | 158 | $85K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 264 | $20K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 149 | $42K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $139K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 215 | $139K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 254 | $1.9M |
| Other(4 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 149 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.