| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC. INSURANCE GROUP INC. | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $4K | $8K | 13.03% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC. INSURANCE GROUP INC. | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $2K | $6K | 17.55% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC. INSURANCE GROUP INC. | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $1K | $6K | 26.71% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC. INSURANCE GROUP INC. | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $636 | $2K | 19.41% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC. INSURANCE GROUP INC. | 1 KELLY WAY SPARKS, MD 21152 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $614 | $2K | 22.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPIPHANY RX EIN 04-3608530 PBM | Claims processing; Contract Administrator Service code 12 | — | $263K |
| CAREFIRST ADMINISTRATORS EIN 52-1187907 THIRD PARTY ADMINISTRATO | Claims processing Service code 12 | — | $74K |
| HILB GROUP OF MARYLAND EIN 80-0887008 BROKER | Insurance agents and brokers Service code 22 | — | $41K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $26K |
| CONNECTCARE3, LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $9K |
| CONIFER VALUE-BASED CARE EIN 52-1964905 UTILIZATION MANAGEMENT | Plan Administrator Service code 14 | — | $1K |
| DAVIS VISION INC. EIN 11-3051991 VISION | Insurance services Service code 23 | — | $652 |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 145 | $58K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 193 | $19K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 193 | $32K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 64 | $21K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 141 | $265K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 193 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
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.