| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA & ASSOC FINANCIAL SVCS INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | $31K | $1K | $32K | 5.28% |
| BENEFITMALL3 Filed as: MATHER & STROHL DBA BENEFITMALL | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | $7K | $890 | $8K | 1.33% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $172 | $18K | $18K | 3.18% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES, INC. | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | $124 | $18K | $18K | 3.11% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA & ASSOC FNCL SVCS, INC. | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 4.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $106 | — | $106 | 0.47% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA & ASSOC FINANCIAL SVCS | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $985 | $3K | 14.16% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $168 | — | $168 | 0.85% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $963 | $963 | 4.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $167 | — | $167 | 0.85% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $889 | $889 | 4.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $162 | — | $162 | 0.85% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $271 | $271 | 5.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC, INC | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33 | — | $33 | 0.67% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES, INC. | 1445 RESEARCH BLVD. SUITE 340 ROCKVILLE, MD 20850 | NGL | $423 | — | $423 | 9.99% |
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 | 347 | 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) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | 112 | $1.2M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 27 | $23K |
| Vision(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 112 | $573K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 273 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 75 | $20K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 75 | $20K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES, INC. | 112 | $568K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 273 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.