| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | CAREFIRST BLUECHOICE, INC. | — | $39K | $39K | 4.90% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINISTRATORS INC | 6 NORTH PARK DRIVE S310 HUNT VALLEY, MD 21030 | CAREFIRST BLUECHOICE, INC. | — | $12K | $12K | 1.52% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 600 SYLVAN AVE SUITE 301 ENGLEWOOD CLIFFS, NJ 07632 | CAREFIRST BLUECHOICE, INC. | — | $9K | $9K | 1.17% |
| JOSEPH P CALARCO3 Filed as: JOSEPH APPELBAUM | 13816 GLEN MILL ROAD ROCKVILLE, MD 20850 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | — | $19K | 10.81% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 1803 RESEARCH BLVD, SUITE 604 ROCKVILLE, MD 20850 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $7K | $7K | 4.12% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINISTRATORS INC | 6 NORTH PARK DRIVE SUITE 310 HUNT VALLEY, MD 21030 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.00% |
| POTOMAC INSURANCE INC3 | 1803 RESEARCH BLVD SUITE 604 ROCKVILLE, MD 20850 | LEGAL RESOURCES | $259 | — | $259 | 5.46% |
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 | 111 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 90 | $800K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $178K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $178K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $178K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $178K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $178K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 90 | $800K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 111 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.