| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD | 575 S CHARLES STREET-STE 300 BALTIMORE, MD 21201 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $26K | $5K | $31K | 4.78% |
| AMWINS3 Filed as: AMWINS CONNECT ADMINISTRATORS INC. | 6 NORTH PARK DRIVE, SUITE 310 HUNT VALLEY, MD 21030 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $8K | — | $8K | 1.20% |
| DONALD R RAJALA3 | 1802 GREENBLADE COURT BELAIR, MD 21015 | AFLAC | $7K | $78 | $7K | 8.86% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD | 575 S CHARLES ST-SUITE 300 BALTIMORE, MD 20853 | AFLAC | $2K | — | $2K | 2.71% |
| BRADLEY BAWEK3 | 4809 POWDER HOUSE DRIVE ROCKVILLE, MD 20853 | AFLAC | $1K | $14 | $1K | 1.32% |
| BRYAN FISH3 | 4050 CANDLE LIGHT DRIVE DAYTON, MD 21036 | AFLAC | $855 | $18 | $873 | 1.12% |
| DAVID NERENBERG3 | 61 CALABASH COURT ROCKVILLE, MD 20850 | AFLAC | $747 | — | $747 | 0.96% |
| SUSAN S STRICKLAND3 Filed as: SUSAN STRICKLAND | 2194 SUGARLOAF PARKVIEW LANE CLARKSBURG, MD 20871 | AFLAC | $530 | — | $530 | 0.68% |
| EDWARD ANDERSON JR3 | 10003 RIDER COURT HAGERSTOWN, MD 21740 | AFLAC | $363 | — | $363 | 0.46% |
| MARK JOHNSTON3 Filed as: MARK A JOHNSTON | 79 STAYMAN DRIVE FALLING WATERS, WV 25419 | AFLAC | $265 | — | $265 | 0.34% |
| ALYSON D ROTHBERG3 | 35 BITTLE ROAD LITTLESTOWN, PA 17340 | AFLAC | $235 | — | $235 | 0.30% |
| STEPHEN MANYARA3 | 3111 MAPLEWOOD ROAD AMES, IA 50014 | AFLAC | $160 | $43 | $203 | 0.26% |
| FRANCES SHAFFER3 Filed as: FRANCES M SHAFFER | 14025 TOWER ROAD SMITHSBURG, MD 21783 | AFLAC | $162 | — | $162 | 0.21% |
| RICKY E ROBINSON3 | 934 SWEENY DRIVE-STE ONE HAGERSTOWN, MD 21740 | AFLAC | $149 | — | $149 | 0.19% |
| RUANN M EMERSON3 | 1017 ASHES DRIVE - STE 106 WILMINGTON, NC 28405 | AFLAC | $147 | — | $147 | 0.19% |
| KIMBERLY L LUSHBAUGH3 | 14 CATAWBA CIRCLE HAGERSTOWN, MD 21742 | AFLAC | $146 | — | $146 | 0.19% |
| MICHAEL C WALKER3 | 203 MARKET STREET-STE 201 HAVRE DE GRACE, MD 21078 | AFLAC | $101 | — | $101 | 0.13% |
| KENNETH B COFER3 | 5950 SYMPHONY WOODS ROAD - STE 214 COLUMBIA, MD 21044 | AFLAC | $94 | — | $94 | 0.12% |
| ARON D TERAN3 | 3812 CARRIAGE HILL DRIVE FREDERICK, MD 21704 | AFLAC | $65 | — | $65 | 0.08% |
| THE DIAMOND AGENCY LLC3 | 2013 OLD RIDGE WAY - SUITE 150 #202 LELAND, NC 28451 | AFLAC | $54 | — | $54 | 0.07% |
| MICHAEL EDWARD RISKA3 | 203 MARKET STREET, STE 201 HAVRE DE GRACE, MD 21078 | AFLAC | $39 | — | $39 | 0.05% |
| JASON D ELLIS3 | 1 ELLIS COURT-STE 210 PERRYVILLE, MD 21903 | AFLAC | $20 | — | $20 | 0.03% |
| JAMES M PITZ3 | 84 MINK DRIVE CATAULA, GA 31804 | AFLAC | $14 | — | $14 | 0.02% |
| GREGORY D HILL3 | 16142 SWALLOWTAIL PLACE MIDLOTHIAN, VA 23113 | AFLAC | $6 | — | $6 | 0.01% |
| BENJAMIN KLINGER3 | 5503 SPRUCE TREE AVE BETHESDA, MD 20814 | AFLAC | $3 | — | $3 | 0.00% |
| KENNETH B COFER3 | 5950 SYMPHONY WOODS ROAD-STE 214 COLUMBIA, MD 21044 | AFLAC | $2 | — | $2 | 0.00% |
| ANGELE P RYAN3 | 852 SAINT EDMONDS PLACE ANNAPOLIS, MD 21401 | AFLAC | $1 | — | $1 | 0.00% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD | 575 S CHARLES STREET - SUITE 300 BALTIMORE, MD 21201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 17.36% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINISTRATORS, INC. | 6 N PARK ST - SUITE 310 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $868 | $868 | 2.72% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD INC | 575 S CHARLES ST - SUITE 300 BALTIMORE, MD 21201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $6K | 20.11% |
| AMWINS5 Filed as: AMWINS ADMINISTRATORS, INC. | 6 N PARK DRIVE-STE 310 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $744 | $744 | 2.72% |
| AMWINS3 Filed as: AMWINS CONNECT ADMINISTRATORS, INC. | 6 NORTH PARK DRIVE, SUITE 310 HUNT VALLEY, MD 21030 | UNITED CONCORDIA INSURANCE COMPANY | $56 | $969 | $1K | 5.63% |
| EMPLOYEE ONE BENEFIT SOLUTIONS, LLC3 Filed as: EMPLOYEE BENEFIT SERVICES OF MD | 575 S CHARLES ST - SUITE 300 BALTIMORE, MD 21201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.38% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINSITRATORS | 6 NORTH PARK DRIVE-SUITE 310 HUNT VALLEY, MD 21030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $456 | $456 | 2.72% |
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 | 177 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 76 | $641K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 48 | $18K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 82 | $5K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 177 | $95K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 177 | $27K |
| Other(2 contracts, 2 carriers) | AFLAC | 177 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 177 | — |
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.