| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC. | 1445 RESEARCH BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $53K | $0 | $53K | 4.22% |
| ALAN J ZUCCARI INC3 Filed as: ALAN J. ZUCCARI INC. | 4100 MONUMENT CORNER DRIVE SUITE 500 FAIRFAX, VA 22030 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $13K | $2K | $15K | 1.20% |
| 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 | $13K | $5K | $19K | 21.10% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE, SUITE 401 ROCKVILLE, MD 20874 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $143 | $2K | 4.04% |
| KAREN LINDER-STAUBS3 | 2510 PROCTOR LANE BALTIMORE, MD 21234 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 3.83% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE, APT 113 FAIRFAX, VA 22031 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $109 | $0 | $109 | 0.27% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $109 | $0 | $109 | 0.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC | 9713 KEY WEST AVENUE, SUITE 401 ROCKVILLE, MD 20874 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $136 | $3K | 6.65% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 6.46% |
| KAREN LINDER-STAUBS3 | 2510 PROCTOR LANE BALTIMORE, MD 21234 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.53% |
| SONIA A VIDAL-AWBREY3 Filed as: SONIA A. VIDAL-AWBREY | 2665 PROSPERITY AVENUE, APT 113 FAIRFAX, VA 22031 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $301 | $0 | $301 | 0.78% |
| ANN MARIE BENT3 | 7551 ORCHID HAMMOCK DRIVE WEST PALM BEACH, FL 33412 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $301 | $0 | $301 | 0.78% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC | 9713 KEY WEST AVENUE, SUITE 401 ROCKVILLE, MD 20850 | GUARDIAN | $1K | $724 | $2K | 15.97% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | 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. | 213 | $1.3M |
| Vision | GUARDIAN | 123 | $12K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $127K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $89K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $89K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 213 | $1.3M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.