| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 11350 MCCORMICK ROAD EXECUTIVE PLAZA 3, SUITE 1203 BALTIMORE, MD 21031 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $3K | $26K | $29K | 3.06% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC. INS. GROUP, INC. | 1 KELLY WAY SPARKS, MD 21152 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $0 | $12K | $12K | 1.21% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOC. INS. GROUP, INC. | 1 KELLY WAY SPARKS, MD 21152 | HARTFORD LIFE AND ACCIDENT | $2K | $1K | $3K | 19.83% |
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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 150 | $956K |
| Dental | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 150 | $956K |
| Vision | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 150 | $956K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 188 | $15K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 188 | $15K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 150 | $956K |
| Other | HARTFORD LIFE AND ACCIDENT | 188 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.