| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 101 WEST MAIN STREET, SUITE 900 WORLD TRADE CENTER NORFOLK, VA 23510 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $11K | $5K | $15K | 2.42% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720B ROCKLEDGE DRIVE, SUITE 400 BETHESDA, MD 20817 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $14K | $0 | $14K | 2.22% |
| MATHER & STROHL ADMIN SVC INC3 Filed as: MATHER & STROHL ADMIN SERVICES | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $8K | $0 | $8K | 1.26% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720B ROCKLEDGE DRIVE, SUITE 400 BETHESDA, MD 20817 | CAREFIRST BLUECHOICE, INC. | $10K | $3K | $13K | 4.69% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 11350 MCCORMICK ROAD EXECUTIVE PLAZA III, SUITE 1203 BALTIMORE, MD 21030 | CAREFIRST BLUECHOICE, INC. | $4K | $7 | $4K | 1.37% |
| MATHER & STROHL ADMIN SVC INC3 Filed as: MATHER & STROHL ADMIN SERVICES | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21284 | CAREFIRST BLUECHOICE, INC. | $0 | $1K | $1K | 0.48% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL LLC | 6720A ROCKLEDGE DRIVE, SUITE 400 BETHESDA, MD 20817 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $6K | $12K | 8.52% |
| MATHER BENEFIT ADMINISTRATORS, LLC3 | 10540 YORK ROAD COCKEYSVILLE, MD 21030 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10K | $10K | 7.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $60 | $6K | 4.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $446 | $446 | 0.32% |
| THE CAPITAL GROUP LLC3 | 6720B ROCKLEDGE DRIVE, SUITE 400 BETHESDA, MD 20817 | VISION SERVICE PLAN | $663 | $0 | $663 | 12.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 261 MADISON AVENUE, FLOOR 5 NEW YORK, NY 10016 | VISION SERVICE PLAN | $292 | $0 | $292 | 5.65% |
| THE CAPITAL GROUP LLC3 Filed as: THE CAPITAL GROUP | 6720A ROCKLEDGE DRIVE, SUITE 400 BETHESDA, MD 20817 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $228 | $0 | $228 | 9.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62939 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $30 | $0 | $30 | 1.21% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 142 | 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 | 132 | $911K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $138K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 41 | $8K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $138K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $138K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $138K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 132 | $911K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 303 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.