| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $33K | — | $33K | 12.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 2.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | SYMETRA LIFE INSURANCE COMPANY | — | $6K | $6K | 3.86% |
| CFA LLC3 | 3928 PENDER DRIVE SUITE 100 FAIRFAX, VA 22030 | SYMETRA LIFE INSURANCE COMPANY | — | $4K | $4K | 2.49% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 5.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | EYEMED | $2K | — | $2K | 2.22% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $927 | — | $927 | 5.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST ADMIN - KELLY & ASSOC EIN 52-1187907 NONE | Insurance agents and brokers; Claims processing; Insurance services; Contract Administrator Service code 12 | — | $428K |
| METROPOLITAN LIFE - KELLY & ASSOC EIN 13-5581829 NONE | Contract Administrator; Insurance agents and brokers; Insurance services; Claims processing Service code 12 | — | $42K |
| CONNECTYOURCARE - KELLY & ASSOC EIN 26-1274092 NONE | Insurance services; Insurance agents and brokers; Contract Administrator Service code 13 | — | $2K |
| HEALTH ADVOCATE EIN 23-3080019 NONE | Contract Administrator Service code 13 | — | $0 |
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 | 1,128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED | 856 | $109K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,228 | $94K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 268 | $279K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 838 | $240K |
| Other(5 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 1,228 | $401K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,228 | — |
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.