| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD EXECUTIVE PLAZA III, SUITE 1203 BALTIMORE, MD 21030 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $101 | $103K | $103K | 3.66% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $22K | $22K | 0.79% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $9K | $13K | 8.29% |
| USI INSURANCE SERVICES LLC3 | PO B OX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.52% |
| USI INSURANCE SERVICES LLC3 | 1750 H STREET NW, SUITE 200 WASHINGTON, DC 20006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $1K | $11K | 8.10% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 5.00% |
| USI INSURANCE SERVICES LLC3 | PO B OX 61007 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $360 | $84 | $444 | 0.32% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE, SUITE 400 FALLS CHURCH, VA 22042 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.92% |
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 | 235 | 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) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 314 | $2.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 220 | $162K |
| Vision | VISION SERVICE PLAN | 222 | $35K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $140K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $140K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $140K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 314 | $2.8M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 235 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.
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.