| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INSURANCE AGENCY & ASSOC. | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $58K | — | $58K | 14.70% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD INC | 575 S CHARLES ST STE 300 BALTIMORE, MD 21201 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $45 | — | $45 | 0.01% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INSURANCE AGENCY & FIN SVC | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.65% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INSURANCE AGENCY & FIN SVC | 8200 GREENSBORO DR SUITE 1550 WEST MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN, INC. | $769 | — | $769 | 2.04% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD INC | 575 S CHARLES ST STE 300 BALTIMORE, MD 21201 | KAISER FOUNDATION HEALTH PLAN, INC. | $535 | — | $535 | 1.42% |
| SAHOURI INSURANCE AGENCY & ASSOC3 | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.36% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INSURANCE AGENCY & FIN SVC | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.67% |
| SAHOURI INSURANCE AGENCY & ASSOC3 | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 14.73% |
| MID ATLANTIC BENEFITS GROUP LLC3 | 203 MARKET ST SUITE 201 HAVRE DE GRACE, MD 21078 | UNUM INSURANCE COMPANY | $2K | $79 | $2K | 12.99% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INS & AGENCY ASSOC INC | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNUM INSURANCE COMPANY | $158 | — | $158 | 0.92% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INS & AGENCY ASSOC INC | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNUM INSURANCE COMPANY | $710 | — | $710 | 4.87% |
| MID ATLANTIC BENEFITS GROUP LLC3 | 203 MARKET ST SUITE 201 HAVRE DE GRACE, MD 21078 | UNUM INSURANCE COMPANY | $2K | $45 | $2K | 12.66% |
| SAHOURI INSURANCE AGENCY & ASSOC3 Filed as: SAHOURI INS AGENCY & ASSOC | 8200 GREENSBORO DR SUITE 1550 MCLEAN, VA 22102 | UNUM INSURANCE COMPANY | $336 | — | $336 | 2.65% |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 448 | $435K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 448 | $398K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 448 | $398K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $64K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $32K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 56 | $34K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 448 | $435K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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.