| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE INDUSTRIE | 307 INTERNATIONAL CIRCLE SUITE 610 HUNT VALLEY, MD 21030 | DOMINION NATIONAL | $948 | — | $948 | 7.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE INDUSTRIES | 307 INTERNATIONAL CIRCLE SUITE 610 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $733 | — | $733 | 9.99% |
| BENEFITMALL3 Filed as: BENEFITMALL INC | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $220 | $220 | 3.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE INDUSTRIES | 307 INTERNATIONAL CIRCLE SUITE 610 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $856 | — | $856 | 15.00% |
| BENEFITMALL3 Filed as: BENEFITMALL INC | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $171 | $171 | 3.00% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE INDUSTRIES | 307 INTERNATIONAL CIRCLE SUITE 610 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $353 | — | $353 | 10.01% |
| BENEFITMALL3 Filed as: BENEFITMALL INC | 501 FAIRMOUNT AVENUE SUITE 400 TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $106 | $106 | 3.01% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE INDUSTRIE | 307 INTERNATIONAL CIRCLE SUITE 610 HUNT VALLEY, MD 21030 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $213 | — | $213 | 9.57% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DOMINION NATIONAL | 86 | $14K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 165 | $2K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 114 | $6K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 0 | $0 |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.