| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 540 FORT EVANS RD NE. SUITE 301 LEESBURG, VA 20176 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $4K | $15K | $19K | 0.70% |
| PSA FINANCIAL, INC.3 Filed as: PSA INS & FINANCIAL PARTNERS LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $2K | $13K | $15K | 0.54% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE SUITE 200 HUNT VALLEY, MD 21030 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | — | $8K | $8K | 0.30% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | $8K | $4K | $12K | 3.73% |
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS LLC DBA INSURAN | 9600 BLACKWELL ROAD, SUITE 225 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC | $2K | — | $2K | 0.58% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 10.11% |
| PSA FINANCIAL, INC.3 Filed as: PSA INS & FINANCIAL PARTNERS LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 9.77% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.05% |
| PSA FINANCIAL, INC.3 Filed as: PSA INS & FINANCIAL PARTNERS LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 9.69% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF MARYLAND LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.06% |
| PSA FINANCIAL, INC.3 Filed as: PSA INS & FINANCIAL PARTNERS LLC | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 9.70% |
| PSA INSURANCE & FINANCIAL PARTNERS3 | 11311 MCCORMICK ROAD SUITE 500 HUNT VALLEY, MD 21031 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS OF MIDATLANTIC | 1414 KEY HIGHWAY - SUITE 300M BALTIMORE, MD 21230 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 9.96% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $554 | $554 | 5.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $50 | $10 | $60 | 18.02% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 148 | $3.1M |
| Dental | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 137 | $2.8M |
| Vision | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 137 | $2.8M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $78K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $46K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $44K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 137 | $2.8M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.