| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING INSURANCE | 71 HANOVER ROAD LOCK BOX GH200 FLORHAM PARK, NJ 07932 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | $17K | $368 | $17K | 2.76% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 9600 BLACKWELL ROAD SUITE 225 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | $5K | — | $5K | 0.80% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF N. CAROLINA LLC | 4010 OLEANDER DRIVE WILMINGTON, NC 28403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $20K | — | $20K | 6.40% |
| ADP INC3 Filed as: AUTOMATIC DATA PROCESSING INSURANCE | 71 HANOVER RD FLORHAM PARK, NJ 07932 | DELTA DENTAL OF VIRGINIA | $7K | — | $7K | 4.97% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF SOUTH CAROLINA LL | 218 TRADE STREET STE G GREER, SC 29651 | DELTA DENTAL OF VIRGINIA | $560 | — | $560 | 0.41% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF SOUTH CAROLINA | 2131 MINISTRY DR IRMO, SC 29063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $3K | $16K | 20.43% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLIGAN & ASSOCIATES LLC | 1933 STATE ROUTE 35 STE 368 WALL TOWNSHIP, NJ 07719 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| ENDEAVOR INSURANCE SERVICES, INC.3 Filed as: ENDEAVOR EMPLOYER SERVICES, INC. | PO BOX 198 GREER, SC 29652 | VISION SERVICE PLAN | $320 | — | $320 | 1.66% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | 120 | $944K |
| Dental | DELTA DENTAL OF VIRGINIA | 250 | $137K |
| Vision | VISION SERVICE PLAN | 90 | $19K |
| Life insurance | AMERICAN ARMED FORCES MUTUAL AID ASSOCIATION | 143 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $78K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $78K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | 120 | $944K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 80 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.