Form 5500 · Employee benefit plan · BETHESDA, MD
MIRACLE SYSTEMS LLC
The filing calls this plan MIRACLE SYSTEMS LLC WELFARE PLAN.
MIRACLE SYSTEMS LLC of BETHESDA, MD spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is JYOTI GUJRAL. Coverage is written through CAREFIRST BLUECHOICE, INC. and 2 other carriers. The plan's most recent policy period ended in November.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 35-2206564 · plan 505 · plan year 2023, filed Oct 15, 2024
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 3 insured contracts covering health, dental, vision, life and disability; the largest, with CAREFIRST BLUECHOICE, INC., covers 211 people.
Reported premium across the insured contracts is $1,880,995, with $14,141 in disclosed broker commissions — about 0.8% of premium.
The most recent policy period ended in November, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
JYOTI GUJRAL is the broker of record on 1 of the 3 contracts; the rest name a different broker or none.
3 carriers appear on the filing, including CAREFIRST BLUECHOICE, INC., UNUM LIFE INSURANCE COMPANY OF AMERICA and STARMOUNT LIFE INSURANCE COMPANY. CAREFIRST BLUECHOICE, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 187 | Dec 1, 2023 | $174,515 | $14,141 |
| CAREFIRST BLUECHOICE, INC. | Health | 211 | Dec 1, 2023 | $1,706,480 | $0 |
| STARMOUNT LIFE INSURANCE COMPANY | Dental, Vision | 187 | Dec 1, 2023 | — | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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