| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HODGE HART & SCHLEIFER INC3 | 8401 CONNECTICUT AVENUE SUITE 600 CHEVY CHASE, MD 20815 | CAREFIRST BLUECHOICE INC | $1K | $25K | $26K | 1.22% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINISTRATORS INC | 11350 MCCORMICK ROAD EXECUTIVE PLAZA IV SUITE 400 HUNT VALLEY, MD 21030 | CAREFIRST BLUECHOICE INC | — | $4K | $4K | 0.20% |
| HODGE HART & SCHLEIFER INC3 | 7979 OLD GEORGETOWN ROAD SUITE 700 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $8K | 12.86% |
| HODGE HART & SCHLEIFER INC3 | 7979 OLD GEORGETOWN ROAD SUITE 700 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 13.16% |
| HODGE HART & SCHLEIFER INC3 | 7979 OLD GEORGETOWN ROAD SUITE 700 BETHESDA, MD 20814 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES INC | $1K | $270 | $1K | 2.72% |
| HODGE HART & SCHLEIFER INC3 | 7979 OLD GEORGETOWN ROAD SUITE 700 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 21.22% |
| HODGE HART & SCHLEIFER INC3 | 7979 OLD GEORGETOWN ROAD SUITE 700 BETHESDA, MD 20814 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.82% |
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAREFIRST BLUECHOICE INC | 91 | $2.2M |
| Dental | CAREFIRST BLUECHOICE INC | 91 | $2.1M |
| Vision | CAREFIRST BLUECHOICE INC | 91 | $2.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $22K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $57K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $66K |
| Prescription drug | CAREFIRST BLUECHOICE INC | 91 | $2.1M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 103 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
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.