| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMERCIAL INSURANCE MANAGERS3 | BOX 2030 8600 FOUNDRY ST SAVAGE, MD 20763 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 8.15% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.88% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST CT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | — | $21K | 46.97% |
| COMMERICAL INSURANCE MANAGERS INC3 | BOX 2030 8600 FOUNDRY ST SAVAGE, MD 20763 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 20.46% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $576 | — | $576 | 1.28% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | SUITE 900 4211 BOYS SCOUT BLVD TAMPA, FL 33607 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $72 | $1 | $73 | 0.16% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.16% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.04% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST CT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 21.17% |
| COMMERICAL INSURANCE MANAGERS INC3 | 8600 FOUNDRY ST BOX 2030 SAVAGE, MD 20763 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 15.42% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $327 | — | $327 | 0.99% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $44 | — | $44 | 0.13% |
| THE BALDWIN GROUP WEST LLC3 Filed as: THE BALDWIN GROUP MID-ATLANTIC, LLC | 4211 BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40 | — | $40 | 0.12% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40 | — | $40 | 0.12% |
| COMMERICIAL INSURANCE MANAGERS3 | BOX 2030 8600 FOUNDRY ST SAVAGE, MD 20763 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 11.75% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $439 | — | $439 | 3.71% |
| MID ATLANTIC BENEFITS GROUP LLC3 | 203 MARKET ST SUITE 201 HAVRE DE GRACE, MD 21078 | TRANSAMERICA LIFE INSURANCE COMPANY | $94 | — | $94 | 1.81% |
| JOSEPH M BRZECZEK3 Filed as: JOSEPH M BRZECKEZ | 1012 W STATE COLLEGE RD SUITE 203 DOVER, DE 19904 | TRANSAMERICA LIFE INSURANCE COMPANY | $76 | — | $76 | 1.46% |
| JOHN J REITH3 Filed as: JOHN REITH | 7010 HOMELAND CT PRINCE FREDERICK, MD 20678 | TRANSAMERICA LIFE INSURANCE COMPANY | $33 | — | $33 | 0.64% |
| JORDAN A PURCELL3 | 72 E ELLENDALE ST BEL AIR, MD 21014 | TRANSAMERICA LIFE INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| JOSEPH M BRZECZEK3 | 1012 COLLEGE RD SUITE 203 DOVER, DE 19904 | AFLAC | $187 | — | $187 | 4.67% |
| JOHN J REITH3 | 1103 SARA LN HINESVILLE, GA 31313 | AFLAC | $75 | — | $75 | 1.87% |
| MID ATLANTIC BENEFITS GROUP LLC3 Filed as: MID ATLANTIC BENEFITS GROUP | 203 MARKET ST STE 210 HAVRE DE GRACE, MD 21078 | AFLAC | $64 | — | $64 | 1.60% |
| MICHAEL C WALKER3 | 203 MARKET ST STE 201 HAVRE DE GRACE, MD 21078 | AFLAC | $53 | — | $53 | 1.32% |
| RAYMOND L CHAN3 | 10400 EATON PL STE FAIRFAX, VA 22030 | AFLAC | $9 | — | $9 | 0.22% |
| JORDON A PURCELL3 | 72 E ELLENDALE ST BEL AIR, MD 21014 | AFLAC | $6 | — | $6 | 0.15% |
| DIVYA JAIN3 | 14155 NEWBROOK DR STE 130 CHANTILLY, VA 20151 | AFLAC | $3 | — | $3 | 0.07% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $74K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $74K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 101 | $74K |
| Other(6 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.