| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 210 ROCKVILLE, MD 20850 | GROUP HOSPITALIZATION MEDICAL SERVICES INC | $3K | $47K | $50K | 4.64% |
| HUB INTERNATIONAL MIDWEST LIMITED5 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 1445 RESEARCH BLVD STE 210 ROCKVILLE, MD 20850 | GROUP HOSPITALIZATION MEDICAL SERVICES INC | $0 | $4K | $4K | 0.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN IF THE MID-ATLANTIC STATES, INC | $50K | — | $50K | 5.77% |
| BENEFITMALL3 Filed as: MATHER & STROHL DBA BENEFITMALL | 501 FAIRMOUNT AVE SUITE 400S TOWSON, MD 21286 | KAISER FOUNDATION HEALTH PLAN IF THE MID-ATLANTIC STATES, INC | $8K | — | $8K | 0.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 3290 N RIDGE RD SUITE 300 ELLICOTT CITY, MD 21043 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.00% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R. NELLGAN & ASSOCIATES LLC | 1933 STATE ROUTE 35, STE 368 WALL TOWNSHIP, NJ 07719 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 203 N LASALLE ST FL 20 CHICAGO, IL 60601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $29 | $29 | 0.06% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.99% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.93% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 400 RIDGEFIELD PARK, NJ 07660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $496 | $2K | 5.88% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 15.41% |
| MS BENEFITS3 | 100 CHALLENGER RD STE 400 RIDGEFIELD PARK, NJ 07660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 9.00% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $741 | $295 | $1K | 8.39% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: HUB INT MID ATL INC DBA RAFFA | 1445 RESEARCH BLVD STE 340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $463 | $1K | 14.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 1445 RESEARCH BLVD STE 210 ROCKVILLE, MD 20850 | NGL | $828 | — | $828 | 10.00% |
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 | 383 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES INC | 96 | $1.9M |
| Dental(2 contracts, 2 carriers) | GROUP HOSPITALIZATION MEDICAL SERVICES INC | 114 | $1.1M |
| Vision | NGL | 133 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 383 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $27K |
| Prescription drug | GROUP HOSPITALIZATION MEDICAL SERVICES INC | 69 | $1.1M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 383 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 383 | — |
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.