| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAKESHORE BENEFIT GROUP INSURANCE3 Filed as: LAKESHORE BENEFIT GROUP | 529 MAIN ST PO BOX 670 NEW HARTFORD, CT 060572111 | METLIFE | $6K | $0 | $6K | 11.58% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CARDAY ASSOCIATES EIN 53-0257019 NONE | Direct payment from the plan; Plan Administrator Service code 14 | 7130 COLUMBIA GATEWAY DR, SUITE A COLUMBIA, MD 21046 | $191K |
| CHARLES R BOTH NONE | Legal; Direct payment from the plan Service code 29 | 1666 CONNECTICUT AVE NW SUITE 5 WASHINGTON, DC 20009 | $20K |
| SALTER & COMPANY, LLC EIN 20-8078757 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 4600 EAST WEST HIGHWAY BETHESDA, MD 20814 | $15K |
| C. ANTHONY MAYO NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $7K |
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 | 363 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 397 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUE CROSS BLUE SHIELD | 822 | $4.5M |
| Dental | CAREFIRST BLUE CROSS BLUE SHIELD | 822 | $4.5M |
| Vision | DAVIS VISION | 901 | $0 |
| Life insurance | METLIFE | 471 | $49K |
| Prescription drug | CAREFIRST BLUE CROSS BLUE SHIELD | 822 | $4.5M |
| Other(2 contracts, 2 carriers) | METLIFE | 471 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.