| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 20850 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $81K | — | $81K | 12.69% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. & FIN. SERVICES | 4851 LBJ FREEWAY, SUITE 1100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $38K | $38K | 5.86% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 20850 | AMERITAS | $7K | $0 | $7K | 7.00% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $303 | $3K | 11.06% |
| BENEFITMALL3 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $913 | $913 | 3.02% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $272 | $3K | 10.90% |
| BENEFITMALL3 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $835 | $835 | 2.98% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 20850 | EYEMED | $2K | $0 | $2K | 8.80% |
| MATHER & STROHL ADMIN SVC INC3 Filed as: MATHER AND STROHL SERVICE | 501 FAIRMOUNT AVENUE TOWSON, MD 21286 | EYEMED | $584 | $0 | $584 | 3.18% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES | 1445 RESEARCH BLVD., #340 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $166 | $2K | 11.30% |
| BENEFITMALL3 Filed as: BENEFITMALL INC. | 501 FAIRMOUNT AVENUE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $498 | $498 | 3.09% |
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 | 305 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 305 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 172 | $641K |
| Dental | AMERITAS | 292 | $101K |
| Vision | EYEMED | 305 | $18K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $16K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $28K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.