401k Plan data: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN plan

MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 401k Plan overview

Plan Name	MARYLAND MANAGEMENT COMPANY BENEFIT PLAN
Plan identification number	502

MARYLAND MANAGEMENT COMPANY BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

MARYLAND MANAGEMENT COMPANY has sponsored the creation of one or more 401k plans.

Company Name: MARYLAND MANAGEMENT COMPANY

Employer identification number (EIN): 520577857

NAIC Classification: 531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARYLAND MANAGEMENT COMPANY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-01-01 ANDREW B. MCCORKILL 2023-10-03 ERIC R. HUSTON 2023-10-03
502 2021-01-01 ANDREW B. MCCORKILL 2022-10-12 ERIC R. HUSTON 2022-10-12
502 2020-01-01 ANDREW B. MCCORKILL 2021-09-29 ERIC R. HUSTON 2021-09-29
502 2019-01-01 ANDREW B. MCCORKILL 2020-10-14 JAMES A. CLAUSON 2020-10-14
502 2018-01-01 ANDREW B. MCCORKILL 2019-10-08 JAMES A. CLAUSON 2019-10-08
502 2017-01-01
502 2016-01-01
502 2015-01-01
502 2014-01-01
502 2013-01-01
502 2012-01-01 ERIC R. HUSTON
502 2011-01-01 ERIC R. HUSTON
502 2010-01-01 JACQUELINE REARDON
502 2009-01-01 JACQUELINE REARDON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2022-01-01	ANDREW B. MCCORKILL	2023-10-03	ERIC R. HUSTON	2023-10-03
502	2021-01-01	ANDREW B. MCCORKILL	2022-10-12	ERIC R. HUSTON	2022-10-12
502	2020-01-01	ANDREW B. MCCORKILL	2021-09-29	ERIC R. HUSTON	2021-09-29
502	2019-01-01	ANDREW B. MCCORKILL	2020-10-14	JAMES A. CLAUSON	2020-10-14
502	2018-01-01	ANDREW B. MCCORKILL	2019-10-08	JAMES A. CLAUSON	2019-10-08
502	2017-01-01
502	2016-01-01
502	2015-01-01
502	2014-01-01
502	2013-01-01
502	2012-01-01	ERIC R. HUSTON
502	2011-01-01	ERIC R. HUSTON
502	2010-01-01	JACQUELINE REARDON
502	2009-01-01	JACQUELINE REARDON

Plan Statistics for MARYLAND MANAGEMENT COMPANY BENEFIT PLAN

401k plan membership statisitcs for MARYLAND MANAGEMENT COMPANY BENEFIT PLAN

Measure Date Value
2022: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 306
Total of all active and inactive participants 2022-01-01 306
2021: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 316
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 243
Total of all active and inactive participants 2021-01-01 243
2020: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 249
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 316
Total of all active and inactive participants 2020-01-01 316
2019: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 319
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 249
Total of all active and inactive participants 2019-01-01 249
2018: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 335
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 319
Total of all active and inactive participants 2018-01-01 319
2017: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 363
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 335
Total of all active and inactive participants 2017-01-01 335
2016: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 334
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 363
Total of all active and inactive participants 2016-01-01 363
2015: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 331
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 334
Total of all active and inactive participants 2015-01-01 334
2014: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 316
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 331
Total of all active and inactive participants 2014-01-01 331
2013: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 257
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 316
Total of all active and inactive participants 2013-01-01 316
2012: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 439
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 562
Total of all active and inactive participants 2012-01-01 562
2011: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 749
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 439
Total of all active and inactive participants 2011-01-01 439
2010: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 510
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 749
Total of all active and inactive participants 2010-01-01 749
Total participants 2010-01-01 749
2009: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 368
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 510
Total of all active and inactive participants 2009-01-01 510
Total participants 2009-01-01 510

Measure	Date	Value
2022: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	306
Total of all active and inactive participants	2022-01-01	306
2021: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	316
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	243
Total of all active and inactive participants	2021-01-01	243
2020: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	249
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	316
Total of all active and inactive participants	2020-01-01	316
2019: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	319
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	249
Total of all active and inactive participants	2019-01-01	249
2018: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	335
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	319
Total of all active and inactive participants	2018-01-01	319
2017: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	363
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	335
Total of all active and inactive participants	2017-01-01	335
2016: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	334
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	363
Total of all active and inactive participants	2016-01-01	363
2015: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	331
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	334
Total of all active and inactive participants	2015-01-01	334
2014: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	316
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	331
Total of all active and inactive participants	2014-01-01	331
2013: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	257
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	316
Total of all active and inactive participants	2013-01-01	316
2012: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	439
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	562
Total of all active and inactive participants	2012-01-01	562
2011: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	749
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	439
Total of all active and inactive participants	2011-01-01	439
2010: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	510
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	749
Total of all active and inactive participants	2010-01-01	749
Total participants	2010-01-01	749
2009: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	368
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	510
Total of all active and inactive participants	2009-01-01	510
Total participants	2009-01-01	510

Form 5500 Responses for MARYLAND MANAGEMENT COMPANY BENEFIT PLAN

2022: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Mulitple employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Mulitple employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Mulitple employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Multi-employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: MARYLAND MANAGEMENT COMPANY BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Multi-employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

011996

Policy instance

Insurance contract or identification number	011996
Number of Individuals Covered	251
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $13,413
Total amount of fees paid to insurance company	USD $3,353
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $67,067
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,413
Insurance broker organization code?	3
Amount paid for insurance broker fees	3353
Additional information about fees paid to insurance broker	BONUS

CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 )

Policy contract number

2GKP

Policy instance

Insurance contract or identification number	2GKP
Number of Individuals Covered	301
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-21
Total amount of commissions paid to insurance broker	USD $4,746
Total amount of fees paid to insurance company	USD $2,587
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $94,924
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,746
Amount paid for insurance broker fees	438
Additional information about fees paid to insurance broker	PERSISTENCY BONUS
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0149701

Policy instance

Insurance contract or identification number	0149701
Number of Individuals Covered	330
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $1,479
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,998,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,479
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

886680G

Policy instance

Insurance contract or identification number	886680G
Number of Individuals Covered	247
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,316
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1316
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0149701

Policy instance

Insurance contract or identification number	0149701
Number of Individuals Covered	584
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,339
Total amount of fees paid to insurance company	USD $7,500
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,499,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,210
Amount paid for insurance broker fees	7500
Additional information about fees paid to insurance broker	2021 Q1 FULLY INSURED NEW SALES CREDIT - FL
Insurance broker organization code?	3

CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 )

Policy contract number

2GKP

Policy instance

Insurance contract or identification number	2GKP
Number of Individuals Covered	310
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,172
Total amount of fees paid to insurance company	USD $2,664
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $83,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,172
Amount paid for insurance broker fees	470
Additional information about fees paid to insurance broker	PERSISTENCY BONUS
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

886680G

Policy instance

Insurance contract or identification number	886680G
Number of Individuals Covered	226
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $9,669
Total amount of fees paid to insurance company	USD $3,290
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $87,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,271
Amount paid for insurance broker fees	3290
Insurance broker organization code?	3

CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 )

Policy contract number

2GKP

Policy instance

Insurance contract or identification number	2GKP
Number of Individuals Covered	316
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,025
Total amount of fees paid to insurance company	USD $4,478
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $70,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,358
Amount paid for insurance broker fees	1730
Additional information about fees paid to insurance broker	NEW BUSINESS BONUS
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

886680G

Policy instance

Insurance contract or identification number	886680G
Number of Individuals Covered	249
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $9,185
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $83,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,221
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3342546

Policy instance

Insurance contract or identification number	3342546
Number of Individuals Covered	196
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,305
Total amount of fees paid to insurance company	USD $111,249
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,227,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $887
Amount paid for insurance broker fees	74435
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3342546

Policy instance

Insurance contract or identification number	3342546
Number of Individuals Covered	184
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,125
Total amount of fees paid to insurance company	USD $98,603
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,863,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,125
Amount paid for insurance broker fees	98603
Additional information about fees paid to insurance broker	BENEFIT ADVISOR PAYMENTS
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

886680G

Policy instance

Insurance contract or identification number	886680G
Number of Individuals Covered	249
Insurance policy start date	2018-12-01
Insurance policy end date	2019-11-30
Total amount of commissions paid to insurance broker	USD $3,404
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,404
Insurance broker organization code?	3

DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )

Policy contract number

179784

Policy instance

Insurance contract or identification number	179784
Number of Individuals Covered	85
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,673
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,673

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0753455

Policy instance

Insurance contract or identification number	0753455
Number of Individuals Covered	319
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $125,844
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,944,165
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $98,072
Insurance broker organization code?	3

DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )

Policy contract number

179784

Policy instance

Insurance contract or identification number	179784
Number of Individuals Covered	159
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,629
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $74,713
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,629

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5478963

Policy instance

Insurance contract or identification number	5478963
Number of Individuals Covered	246
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $3,054
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,054
Insurance broker organization code?	3

DOMINIONNATIONAL DENTAL (National Association of Insurance Commissioners NAIC id number: 95657 )

Policy contract number

179784

Policy instance

Insurance contract or identification number	179784
Number of Individuals Covered	167
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $8,477
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $77,624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,477
Insurance broker name	CORPORATE COVERAGE LLC

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5478963

Policy instance

Insurance contract or identification number	5478963
Number of Individuals Covered	254
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,450
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,450
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0753455

Policy instance

Insurance contract or identification number	0753455
Number of Individuals Covered	335
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $120,908
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,740,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $88,014
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

DENTAQUEST MID-ATLANTIC, INC. (National Association of Insurance Commissioners NAIC id number: 52040 )

Policy contract number

025278

Policy instance

Insurance contract or identification number	025278
Number of Individuals Covered	308
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $8,466
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $70,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,466
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95094 )

Policy contract number

0837614HNO

Policy instance

Insurance contract or identification number	0837614HNO
Number of Individuals Covered	334
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $22,917
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $1,441,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,526
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0837614

Policy instance

Insurance contract or identification number	0837614
Number of Individuals Covered	32
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,528
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $159,160
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,486
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0753455

Policy instance

Insurance contract or identification number	0753455
Number of Individuals Covered	107
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,790
Total amount of fees paid to insurance company	USD $169
Health Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,008
Insurance broker organization code?	3
Amount paid for insurance broker fees	169
Additional information about fees paid to insurance broker	BONUS AMOUNT
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000ARCI

Policy instance

Insurance contract or identification number	G000ARCI
Number of Individuals Covered	249
Insurance policy start date	2014-12-01
Insurance policy end date	2015-12-01
Total amount of commissions paid to insurance broker	USD $3,553
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $31,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,553
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0837614

Policy instance

Insurance contract or identification number	0837614
Number of Individuals Covered	35
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $10,256
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $164,852
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,889
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

753455

Policy instance

Insurance contract or identification number	753455
Number of Individuals Covered	174
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $7,668
Total amount of fees paid to insurance company	USD $205
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,841
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	FOR THEIR ROLE AS THIRD PARTY ADMINISTRATOR.
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

DENTAQUEST MID-ATLANTIC, INC. (National Association of Insurance Commissioners NAIC id number: 52040 )

Policy contract number

025278

Policy instance

Insurance contract or identification number	025278
Number of Individuals Covered	289
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $8,620
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $71,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,620
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

0837614HNO

Policy instance

Insurance contract or identification number	0837614HNO
Number of Individuals Covered	331
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $88,361
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $1,411,389
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $67,970
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

753455

Policy instance

Insurance contract or identification number	753455
Number of Individuals Covered	316
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $80,736
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,714,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $55,967
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP INC.

DENTAQUEST MID-ATLANTIC, INC. (National Association of Insurance Commissioners NAIC id number: 52040 )

Policy contract number

0252780001

Policy instance

Insurance contract or identification number	0252780001
Number of Individuals Covered	288
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $8,356
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $69,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,356
Insurance broker organization code?	3
Insurance broker name	KELLY & ASSOC INSURANCE GROUP, INC.

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5455946

Policy instance

Insurance contract or identification number	5455946
Number of Individuals Covered	249
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Total amount of commissions paid to insurance broker	USD $3,294
Total amount of fees paid to insurance company	USD $435
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,878
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,294
Amount paid for insurance broker fees	435
Additional information about fees paid to insurance broker	PRODUCER BONUS PROGRAM PAYMENT FOR THE PRIOR CALENDAR YEAR
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )

Policy contract number

17FP

Policy instance

Insurance contract or identification number	17FP
Number of Individuals Covered	183
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $61,841
Total amount of fees paid to insurance company	USD $14,475
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,766,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $61,841
Amount paid for insurance broker fees	14475
Additional information about fees paid to insurance broker	MEDICAL CONTRACTS X PCPM NON-MONETARY INCENTIVE AMOUNT
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

382162

Policy instance

Insurance contract or identification number	382162
Number of Individuals Covered	122
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,504
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,504
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5455946

Policy instance

Insurance contract or identification number	5455946
Number of Individuals Covered	257
Insurance policy start date	2011-12-01
Insurance policy end date	2012-11-30
Total amount of commissions paid to insurance broker	USD $2,883
Total amount of fees paid to insurance company	USD $425
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,883
Amount paid for insurance broker fees	425
Additional information about fees paid to insurance broker	PRODUCER BONUS PROGRAM PAYMENT
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE LLC

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )

Policy contract number

17FP

Policy instance

Insurance contract or identification number	17FP
Number of Individuals Covered	189
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $71,325
Total amount of fees paid to insurance company	USD $14,768
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,783,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )

Policy contract number

5455946

Policy instance

Insurance contract or identification number	5455946
Number of Individuals Covered	250
Insurance policy start date	2010-12-01
Insurance policy end date	2011-11-30
Total amount of commissions paid to insurance broker	USD $2,799
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DENTAQUEST MID-ATLANTIC, INC. (National Association of Insurance Commissioners NAIC id number: 52040 )

Policy contract number

025278-5401

Policy instance

Insurance contract or identification number	025278-5401
Number of Individuals Covered	145
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,622
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $38,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,622
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	BENEFITMALL

DENTAQUEST MID-ATLANTIC, INC. (National Association of Insurance Commissioners NAIC id number: 52040 )

Policy contract number

025278-4501

Policy instance

Insurance contract or identification number	025278-4501
Number of Individuals Covered	165
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,153
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,153
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	BENEFITMALL

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010012111 00

Policy instance

Insurance contract or identification number	000010012111 00
Number of Individuals Covered	249
Insurance policy start date	2009-12-01
Insurance policy end date	2010-11-30
Total amount of commissions paid to insurance broker	USD $3,091
Total amount of fees paid to insurance company	USD $2,793
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,091
Amount paid for insurance broker fees	2793
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE

GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 )

Policy contract number

17FP

Policy instance

Insurance contract or identification number	17FP
Number of Individuals Covered	190
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $73,309
Total amount of fees paid to insurance company	USD $78
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,832,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $73,309
Amount paid for insurance broker fees	78
Additional information about fees paid to insurance broker	NON-MONETARY INCENTIVE AMOUNT
Insurance broker organization code?	3
Insurance broker name	CORPORATE COVERAGE

Potentially related plans

MARYLAND MANAGEMENT & RESTORATION 401(K) PLAN [EIN = 272197787]

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Company Name:	MARYLAND MANAGEMENT COMPANY
Employer identification number (EIN):	520577857
NAIC Classification:	531310