| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN LLC | 4900 LIBBIE MILL EAST BLVD 100 RICHMOND, VA 23230 | CAREFIRST BLUECHOICE | $40K | $0 | $40K | 2.21% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 75 JOHN ROBERTS RD BLDG C SOUTH PORTLAND, ME 04112 | CAREFIRST BLUECHOICE | $23K | $16K | $39K | 2.17% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY & ASSOC INSURANCE GROUP | 1 KELLY WAY SPARKS, MD 21152 | CAREFIRST BLUECHOICE | $0 | $6K | $6K | 0.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 4900 LIBBIE MILL EAST BLVD #100 RICHMOND, VA 23230 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | $0 | $14K | 2.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 23514 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.01% |
| USI INSURANCE SERVICES LLC3 | 2400 E COMMERCIAL BLVD STE 600 FORT LAUDERDALE, FL 33308 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | $0 | $18K | 8.51% |
| MARSH & MCLENNAN AGENCY LLC3 | 4900 LIBBIE MILL EAST BLVD #100 RICHMOND, VA 23230 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 2.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 235143716 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 1.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI UNS SERVICES LLC | PO BOX 3716 NORFOLK, VA 235143716 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $24 | $24 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 8144 WALNUT HILL LANE 15TH FL DALLAS, TX 75231 | VISION SERVICE PLAN | $651 | $0 | $651 | 2.75% |
| USI INSURANCE SERVICES LLC3 | 408 9TH STREET HUNTINGTON, WV 257011418 | VISION SERVICE PLAN | $565 | $0 | $565 | 2.39% |
| SUSAN S STRICKLAND3 Filed as: SUSAN STRICKLAND | 2194 SUGARLOAF PARVIEW LN CLARKSBURG, MD 20871 | AFLAC | $2K | $0 | $2K | 10.10% |
| MICHELLE RANKIN3 | 5004 SAINT SIMON CT FREDERICK, MD 21703 | AFLAC | $286 | $0 | $286 | 1.38% |
| FRANCES SHAFFER3 Filed as: FRANCES SHATTER | 14025 TOWER RD SMITHSBURG, MD 21783 | AFLAC | $277 | $0 | $277 | 1.34% |
| EDWIN VEGA3 | 134 PINECOVE AVE ODENTON, MD 21113 | AFLAC | $219 | $0 | $219 | 1.06% |
| JEREMY HOELKER3 | 10400 EATON PL STE 400 FAIRFAX, VA 22030 | AFLAC | $141 | $0 | $141 | 0.68% |
| MARK JOHNSTON3 | 934 SWEENEY DR #8 HAGERSTOWN, MD 21740 | AFLAC | $74 | $0 | $74 | 0.36% |
| KARIE LYNN HOOTMAN3 Filed as: KARIE HOOTMAN | 34 N HOWELL ST HILLSDALE, MI 49242 | AFLAC | $36 | $0 | $36 | 0.17% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAREFIRST BLUECHOICE | 300 | $2.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 362 | $610K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 130 | $503K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 152 | $344K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 152 | $212K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 152 | $344K |
| Prescription drug | CAREFIRST BLUECHOICE | 300 | $1.8M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 152 | $844K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 362 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.