| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEIL SIMONS3 | GALLAGHER BENEFIT SERVICES, INC. 15900 CRABBS BRANCH WAY STE 350 ROCKVILLE, MD 20855 | EVERGREEN HEALTH COOPERATIVE | $22K | $0 | $22K | 3.50% |
| BENEFITMALL5 | 501 FAIRMOUNT AVENUE #400 TOWSON, MD 21286 | EVERGREEN HEALTH COOPERATIVE | $0 | $9K | $9K | 1.50% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD SUITE 130 ANNAPOLIS, MD 214013064 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 9.93% |
| JON S FRANK & ASSOCIATES INC3 Filed as: JON S FRANK & ASSOCIATES INC. | 205 W DARES BEACH RD PRINCE FREDERICK, MD 206783123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4000 MIDLANTIC DRIVE SUITE 300 MOUNT LAUREL, NJ 08054 | DOMINION NATIONAL | $1K | $0 | $1K | 4.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY SUITE 350 ROCKVILLE, MD 20855 | DOMINION NATIONAL | $640 | $0 | $640 | 2.47% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER ROAD SUITE 130 ANNAPOLIS, MD 214013064 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $129 | $1K | 7.51% |
| JON S FRANK & ASSOCIATES INC3 Filed as: JON S FRANK & ASSOCIATES INC. | 205 W DARES BEACH RD PRINCE FREDERICK, MD 206783123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $518 | $0 | $518 | 3.31% |
| ISI OF MARYLAND LLC3 | 170 JENNIFER RD SUITE 130 ANNAPOLIS, MD 214013064 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $437 | $2K | 13.15% |
| JON S FRANK & ASSOCIATES INC3 | 205 W DARES BEACH RD PRINCE FREDERICK, MD 206783123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $676 | $0 | $676 | 5.24% |
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 | 98 | 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) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EVERGREEN HEALTH COOPERATIVE | 51 | $622K |
| Dental | DOMINION NATIONAL | 48 | $26K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 64 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 40 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 98 | $30K |
| Prescription drug | EVERGREEN HEALTH COOPERATIVE | 51 | $622K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 64 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 98 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.