| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | CAREFIRST BLUECHOICE, INC. | $44K | $58 | $44K | 3.50% |
| MADS INSURANCE AGENCY3 Filed as: MADS INSURANCE AGENCY INC. | 7 STATE CIRCLE # 301 ANNAPOLIS, MD 21031 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 4.52% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 3.33% |
| WANADA BUSINESS SERVICES CORP.3 | 5301 WISCONSIN AVENUE NW #210 WASHINGTON, DC 20015 | AMERICAN FIDELITY ASSURANCE COMPANY | $263 | — | $263 | 0.39% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES | 6 NORTH PARK DRIVE # 310 HUNT VALLEY, MD 21030 | DENTAQUEST MID-ATLANTIC, INC. | $8K | — | $8K | 12.00% |
| MADS INSURANCE AGENCY3 | 7 STATE CIRCLE #301 ANNAPOLIS, MD 21401 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.44% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 3.43% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE CO. | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $511 | — | $511 | 1.03% |
| MADS INSURANCE AGENCY3 Filed as: MADS INSURANCE AGENCY INC. | 7 STATE CIRCLE #301 ANNAPOLIS, MD 21401 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.70% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 3.90% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $779 | — | $779 | 1.57% |
| MADS INSURANCE AGENCY3 | 7 STATE CIRCLE #301 ANNAPOLIS, MD 21401 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.84% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.27% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE CO. | P.O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 3.94% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD, SUITE 500 HUNT VALLEY, MD 21031 | DOMINION NATIONAL | $1K | — | $1K | 7.00% |
| AMERICAN FIDELITY GENERAL AGENCY3 | 200 N CLASSEN BLVD. OKLAHOMA CITY, OK 73106 | AMERICAN UNITED LIFE INSURANCE COMPANY | $359 | — | $359 | 5.08% |
| PSA FINANCIAL, INC.3 | 11311 MCCORMICK ROAD, SUITE 500 HUNT VALLEY, MD 21031 | AMERICAN UNITED LIFE INSURANCE COMPANY | $359 | — | $359 | 5.08% |
| AMERICAN UNITED LIFE3 | ONE AMERICAN SQUARE P.O. BOX 6123 INDIANAPOLIS, IN 46206 | AMERICAN UNITED LIFE INSURANCE COMPANY | $151 | — | $151 | 2.14% |
| MADS INSURANCE AGENCY3 | 7 STATE CIRCLE #301 ANNAPOLIS, MD 21401 | AMERICAN FIDELITY ASSURANCE COMPANY | $53 | — | $53 | 4.97% |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 2 carriers) | CAREFIRST BLUECHOICE, INC. | 141 | $1.5M |
| Dental(2 contracts, 2 carriers) | DENTAQUEST MID-ATLANTIC, INC. | 250 | $87K |
| Life insurance(5 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 253 | $205K |
| Short-term disability(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 32 | $150K |
| Long-term disability(4 contracts) | AMERICAN FIDELITY ASSURANCE COMPANY | 32 | $198K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 141 | $1.3M |
| Other(5 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 253 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 253 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.