| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | AETNA HEALTH, INC. | $29K | — | $29K | 2.02% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS GLENCOE, MD 21152 | HARTFORD LIFE AND ACCIDENT | $10K | $14K | $24K | 13.70% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY AND ASSOCIATES INSURANCE GROU | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $4K | $8K | 12.42% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY RD STE F GREENSBORO, NC 27409 | METROPOLITAN LIFE INSURANCE COMPANY | — | $506 | $506 | 0.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7200 BANK COURT FREDERICK, MD 21703 | METROPOLITAN LIFE INSURANCE COMPANY | — | $34 | $34 | 0.05% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOCIATES INSURANCE GROU | 1 KELLY WAY SPARKS, MD 21152 | METROPOLITAN LIFE INSURANCE COMPANY | — | $12 | $12 | 0.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7200 BANK COURT FREDERICK, MD 21703 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $177 | — | $177 | 1.35% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $52 | — | $52 | 0.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DR STE 1800 GREENSBORO, NC 27406 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 9.18% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKES, MD 211529484 | UNITEDHEALTHCARE INSURANCE COMPANY | $512 | $465 | $977 | 8.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7200 BANK COURT FREDERICK, MD 21703 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $262 | $13 | $275 | 4.58% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 0.95% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $9 | $9 | 0.15% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 243 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 212 | $67K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 165 | $173K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 165 | $179K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 165 | $173K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 243 | $1.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 165 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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."
No prospect flags tripped on this filing.