| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATES INC. | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | CAREFIRST BLUECROSS BLUESHIELD | — | $13K | $13K | 2.01% |
| POTAMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTAMAC BASIN GROUP ASSOCIATES, LLC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $21K | — | $21K | 5.26% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP MID-ATLANTIC SG LLC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MS 20705 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $9K | — | $9K | 2.28% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATES INC. | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 6.51% |
| POTOMAC BASSIN GROUP ASSOC LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATED, INC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | SECURITY LIFE INSURANCE COMPANY OF AMERICA | -$1 | — | -$1 | -0.01% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAREFIRST BLUECROSS BLUESHIELD | 75 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $53K |
| Life insurance(2 contracts, 2 carriers) | SECURITY LIFE INSURANCE COMPANY OF AMERICA | 204 | $19K |
| Prescription drug | CAREFIRST BLUECROSS BLUESHIELD | 75 | $647K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.