| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $222 | $0 | $222 | 7.49% |
| PRESENTLEAVE, LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $74 | $0 | $74 | 2.50% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $423 | $0 | $423 | 15.01% |
| PRESENTLEAVE, LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $141 | $141 | $282 | 10.01% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $133 | $0 | $133 | 8.99% |
| PRESENTLEAVE, LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $44 | $74 | $118 | 7.98% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $54 | $0 | $54 | 14.96% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $51 | $0 | $51 | 14.96% |
| TRIBRIDGE PARTNERS LLC3 | 6721 COLUMBIA GATEWAY DR STE 100 COLUMBIA, MD 21046 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $25 | $0 | $25 | 9.19% |
| PRESENTLEAVE, LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8 | $14 | $22 | 8.09% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | ONE EAST PRATT STREET, SUITE 902 BALTIMORE, MD 21202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $30 | $0 | $30 | 11.41% |
| EMPLOYEE BENEFIT SUBJECT MATTER EXP3 | P.O. BOX 120 MOUNT AIRY, MD 21771 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $9 | $0 | $9 | 3.42% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | ONE EAST PRATT STREET, SUITE 902 BALTIMORE, MD 21202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7 | $0 | $7 | 9.72% |
| EMPLOYEE BENEFIT SUBJECT MATTER EXP3 | P.O. BOX 120 MOUNT AIRY, MD 21771 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2 | $0 | $2 | 2.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $3K |
| TRIBRIDGE PARTNERS, LLC EIN 46-1325247 BROKER | Insurance agents and brokers Service code 22 | — | $2K |
| MERITAIN HEALTH, AN AETNA COMPANY EIN 16-1264154 ADMIN. | Claims processing Service code 12 | — | $489 |
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 | 54 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 55 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 44 | $335 |
| Life insurance | AON INSURANCE SERVICES | 0 | $0 |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 7 | $272 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 76 | $3K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 54 | $18K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 48 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 76 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.