| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 101 WEST MAIN STREET, SUITE 900 NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $40K | $10K | $50K | 6.07% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | ONE KELLY WAY SPARKS, MD 21152 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $23K | — | $23K | 2.76% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $3K | — | $3K | 0.42% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 10.70% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | ONE KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $331 | $25 | $356 | 0.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 2755 HARTLAND ROAD FALLS CHURCH, VA 22043 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $216 | $216 | 0.32% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 406 SOUTH PORTLAND, ME 04112 | GHMSI | $2K | $1K | $3K | 5.88% |
| INSURANCE MARKETING CENTER3 Filed as: INSURANCE MARKETING CENTER INC. | 1101 WOOTEN PARKWAY, SUITE 820 ROCKVILLE, MD 20852 | GHMSI | — | $293 | $293 | 0.55% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | GHMSI | $159 | — | $159 | 0.30% |
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 | 100 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 190 | $822K |
| Dental | GHMSI | 203 | $53K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $68K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $68K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $68K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 190 | $822K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 119 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.