| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 3290 NORTH RIDGE ROAD SUITE 300 ELLICOTT CITY, MD 21043 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $42K | $7K | $49K | 4.33% |
| ALAN J ZUCCARI INC3 | 4100 MONUMENT CORNER DR SUITE 500 FAIRFAX, VA 220308621 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $24K | — | $24K | 2.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $108 | $1K | 3.60% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $973 | — | $973 | 2.68% |
| SONIA A VIDAL-AWBREY3 | 2665 PROSPERITY AVENUE APT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $842 | — | $842 | 2.32% |
| ANN MARIE BENT3 | 4812 WALTONSHIRE CIRCLE OLNEY, MD 20832 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $842 | — | $842 | 2.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $125 | $2K | 7.99% |
| JAY E. BLACK3 Filed as: JAY E BLACK | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.86% |
| SONIA A VIDAL-AWBREY3 | 2665 PROSPERITY AVENUE APT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.06% |
| ANN MARIE BENT3 | 4812 WALTONSHIRE CIRCLE OLNEY, MD 20832 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.06% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $6 | $6 | 0.02% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.74% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $824 | — | $824 | 3.26% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | GUARDIAN | $4K | $862 | $5K | 23.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.75% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $592 | — | $592 | 3.25% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 11.51% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $614 | — | $614 | 3.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 11.73% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE SUITE 401 ROCKVILLE, MD 20850 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $380 | — | $380 | 3.27% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 194 | $1.1M |
| Dental | GUARDIAN | 115 | $22K |
| Vision | GUARDIAN | 115 | $22K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $12K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $25K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.