| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOC LLC | 4740 CORRIDOR PLACE BELTSVILLE, MD 20705 | AETNA LIFE INSURANCE COMPANY | — | $2K | $2K | 7.03% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 4.06% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATION LLC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 14.45% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $590 | $118 | $708 | 5.78% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $590 | $590 | 4.81% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATION LLC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | METROPOLITAN LIFE INSURANCE COMPANY | $586 | — | $586 | 20.26% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $146 | $28 | $174 | 6.02% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $147 | $147 | 5.08% |
| POTOMAC BASIN GROUP ASSOCIATES LLC3 Filed as: POTOMAC BASIN GROUP ASSOCIATION LLC | 4740 CORRIDOR PLACE SUITE B BELTSVILLE, MD 20705 | METROPOLITAN LIFE INSURANCE COMPANY | $228 | — | $228 | 11.17% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $114 | $22 | $136 | 6.66% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $114 | $114 | 5.58% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 90 | $408K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 151 | $30K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 151 | $30K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $12K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $12K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $12K |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 119 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
No prospect flags tripped on this filing.