| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED CONCORDIA INSURANCE COMPANY | $7K | — | $7K | 6.97% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | UNITED CONCORDIA INSURANCE COMPANY | — | $235 | $235 | 0.23% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $3K | $20K | 22.19% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $4K | 4.27% |
| EBSME LLC3 Filed as: EBSME, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $100 | $577 | $677 | 0.76% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $13K | 22.42% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | DBA SALT MARGIN 20 S. KING ST. LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $831 | $2K | $2K | 4.21% |
| EBSME LLC3 Filed as: EBSME, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $77 | $409 | $486 | 0.86% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 18.72% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | DBA SALT MARGIN 20 S. KING ST. LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $641 | $2K | $2K | 3.96% |
| EBSME LLC3 Filed as: EBSME, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $52 | $372 | $424 | 0.78% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | ONE EAST PRATT STREET, SUITE 902 BALTIMORE, MD 21202 | EYEMED | $2K | — | $2K | 7.32% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | D/B/A SALT MARGIN LEESBURG, VA 20175 | EYEMED | $750 | — | $750 | 2.96% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | D/B/A SALT MARGIN MOUNT AIRY, MD 21771 | EYEMED | $519 | — | $519 | 2.05% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $577 | $2K | 19.45% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | DBA SALT MARGIN 20 S. KING STREET LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $143 | $336 | $479 | 3.93% |
| EBSME LLC3 Filed as: EBSME, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13 | $97 | $110 | 0.90% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $522 | $194 | $716 | 20.19% |
| ARMFIELD HARRISON & THOMAS3 Filed as: ARMFIELD, HARRISON & THOMAS, LLC | DBA SALT MARGIN 20 S. KING STREET LEESBURG, VA 20175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $41 | $96 | $137 | 3.86% |
| EBSME LLC3 Filed as: EBSME, LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5 | $33 | $38 | 1.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUN LIFE FINANCIAL EIN 04-3401285 NONE | Contract Administrator Service code 13 | — | $332K |
| SISCO EIN 42-1144827 NONE | Contract Administrator Service code 13 | — | $80K |
| TRIBRIDGE PARTNERS, LLC EIN 46-1325247 NONE | Contract Administrator Service code 13 | — | $49K |
| CIGNA GREAT WEST HEALTH EIN 84-0467907 NONE | Contract Administrator Service code 13 | — | $38K |
| OPTUMHEALTH MTP - UHIC EIN 52-1996029 NONE | Contract Administrator Service code 13 | — | $16K |
| TELADOC HEALTH EIN 04-3705970 NONE | Contract Administrator Service code 13 | — | $2K |
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 | 264 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 328 | $102K |
| Vision | EYEMED | 301 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $69K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $89K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $58K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 207 | $332K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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.