| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | HM LIFE INSURANCE COMPANY | $25K | — | $25K | 10.35% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | DENTAQUEST MIDATLANTIC, INC. | $6K | — | $6K | 7.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 8.65% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 9.11% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 12.04% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | ALLIED EYECARE, LLC D/B/A ADVANTICA EYECARE | $839 | — | $839 | 62.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NCAS - KELLY EIN 52-0546870 NONE | Insurance agents and brokers; Insurance services; Claims processing Service code 12 | — | $87K |
| KELLY & ASSOC - RELIANCE ADMIN EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| KELLY & ASSOCIATES - ADVANTICA ADMI EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| KELLY & ASSOCIATES - DENTAQUEST ADM EIN 52-1066374 NONE | Insurance services Service code 23 | — | $0 |
| TOTAL ADMINISTRATIVE SERVICES - KEL EIN 39-1561025 NONE | Contract Administrator; Insurance services 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 | 188 | 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) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 163 | $56K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 163 | $61K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 163 | $33K |
| Other(3 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 188 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.