| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE RD SUITE 170 ROCKVILLE, MD 20850 | CAREFIRST BLUECHOICE INC | $50K | — | $50K | 6.46% |
| AMWINS3 Filed as: AMWINS CONNECT ADMINISTRATORS INC | 6 NORTH PARK DR S310 HUNT VALLEY, MD 21030 | CAREFIRST BLUECHOICE INC | — | $9K | $9K | 1.12% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE RD SUITE 170 ROCKVILLE, MD 20850 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | $10K | $28K | 18.67% |
| STEVEN D ZITOMER3 Filed as: STEVEN ZITOMER | 11550 OLD GEORGETOWN RD #316 NORTH BETHESDA, MD 20852 | TRANSAMERICA LIFE INSURANCE COMPANY | $730 | — | $730 | 2.80% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE RD SUITE 170 ROCKVILLE, MD 20850 | TRANSAMERICA LIFE INSURANCE COMPANY | $234 | — | $234 | 0.90% |
| KIMBERLY FERGUSON3 | 168 RIDGEWOOD DR OAKLAND, MD 21550 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 1.03% |
| JOHN BETSON | 18202 PRESTWICK DR HAGERSTOWN, MD 21740 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.11% |
| ROBERT J VONGUNTEN3 | 10341 WOODSBORO RD WOODSBORO, MD 21798 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.11% |
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 | 114 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE INC | 96 | $773K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $152K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $152K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $152K |
| Prescription drug | CAREFIRST BLUECHOICE INC | 96 | $773K |
| Other(3 contracts, 3 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.