| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $35K | $9K | $44K | 4.75% |
| EBCA5 Filed as: EBCA GENERAL AGENCY - BDG TPA | 1410 SPRING HILL ROAD SUITE 150 MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $16K | $0 | $16K | 1.76% |
| POTOMAC INSURANCE INC3 Filed as: POTOMAC INSURANCE | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | AETNA | $15K | $0 | $15K | 2.73% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | GUARDIAN LIFE INSURANCE | $8K | — | $8K | 8.62% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 9.01% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 10.91% |
| POTOMAC INSURANCE INC3 | 15825 SHADY GROVE ROAD SUITE 170 ROCKVILLE, MD 20850 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 11.28% |
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 | 188 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 188 | 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 | 147 | $1.5M |
| Dental | GUARDIAN LIFE INSURANCE | 143 | $98K |
| Vision | GUARDIAN LIFE INSURANCE | 143 | $98K |
| Life insurance | STANDARD INSURANCE COMPANY | 188 | $12K |
| Short-term disability | STANDARD INSURANCE COMPANY | 188 | $46K |
| Long-term disability | STANDARD INSURANCE COMPANY | 37 | $36K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 147 | $924K |
| Other | GUARDIAN LIFE INSURANCE | 143 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.