| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS,LLC | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | — | $8K | 6.14% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5K | $5K | 3.97% |
| EBSME LLC3 Filed as: EBSME, LLC | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | — | $3K | 2.05% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 13.49% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 7.27% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $446 | $446 | 0.93% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY SUITE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $213 | $213 | 0.45% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 13.46% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $2K | $3K | 7.26% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $367 | $367 | 0.93% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS, LLC | 40 TIOGA WAY SUITE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $174 | $174 | 0.44% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 14.98% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $753 | $1K | $2K | 7.88% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $235 | $235 | 1.02% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY SUITE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $194 | $194 | 0.84% |
| TRIBRIDGE PARTNERS LLC3 Filed as: TRIBRIDGE PARTNERS | ONE EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 7.49% |
| EBSME LLC3 Filed as: EBSME, LLC | PO BOX 120 MOUNT AIRY, MD 21771 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $660 | — | $660 | 3.21% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY BENEFIT STRATEGIES | 1 KELLY WAY SPARKS, MD 21152 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $660 | — | $660 | 3.21% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | UNITED OF OMAHA LIFE INSURNANCE COMPANY | $2K | $773 | $3K | 13.40% |
| EBSME LLC3 | 4704 DE INVIERNO WAY MOUNT AIRY, MD 21771 | UNITED OF OMAHA LIFE INSURNANCE COMPANY | $649 | $819 | $1K | 7.23% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY AND ASSOC INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | UNITED OF OMAHA LIFE INSURNANCE COMPANY | — | $187 | $187 | 0.92% |
| PROSENTIAL BENEFITS LLC3 Filed as: PROSENTIAL BENEFITS, LLC | 40 TIOGA WAY SUITE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURNANCE COMPANY | — | $87 | $87 | 0.43% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | $760 | — | $760 | 7.50% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | — | $405 | $405 | 4.00% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | $253 | — | $253 | 2.50% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA DENTAL HEALTH OF VIRGINIA, INC. | $183 | — | $183 | 7.51% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SUITE 902 SPARKS, MD 21152 | CIGNA DENTAL HEALTH OF VIRGINIA, INC. | — | $97 | $97 | 3.98% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA DENTAL HEALTH OF VIRGINIA, INC. | $61 | — | $61 | 2.50% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA DENTAL HEALTH OF FLORIDA, INC | $110 | — | $110 | 7.52% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA DENTAL HEALTH OF FLORIDA, INC | — | $58 | $58 | 3.97% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA DENTAL HEALTH OF FLORIDA, INC | $37 | — | $37 | 2.53% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA DENTAL HEALTH OF MISSOURI, INC. | $49 | — | $49 | 7.54% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA DENTAL HEALTH OF MISSOURI, INC. | — | $26 | $26 | 4.00% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA DENTAL HEALTH OF MISSOURI, INC. | $16 | — | $16 | 2.46% |
| TRIBRIDGE PARTNERS LLC3 | 1 EAST PRATT STREET SUITE 902 BALTIMORE, MD 21202 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $20 | — | $20 | 7.38% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | — | $11 | $11 | 4.06% |
| EBSME LLC3 | PO BOX 120 MOUNT AIRY, MD 21771 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $7 | — | $7 | 2.58% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(6 contracts, 6 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 159 | $142K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 459 | $21K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $43K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 193 | $48K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 193 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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.