| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 8200 GREENSBORO DRIVE SUITE 1000 MCLEAN, VA 22102 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $29K | $7K | $36K | 5.21% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 3975 FAIR RIDGE DR SUITE 110 FAIRFAX, VA 220332911 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 47 AIRPARK CT. PO BOX 27149 GREENVILLE, SC 296162149 | AMERITAS LIFE INSURANCE CORP. | — | $2K | $2K | 2.98% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $2K | $93 | $2K | 9.06% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $268 | — | $268 | 1.19% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $133 | $22 | $155 | 0.69% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $89 | $22 | $111 | 0.49% |
| GREER INSURANCE3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILE, MD 21108 | AFLAC | $25 | — | $25 | 0.11% |
| DALE SHADDOCK3 | 8927 MAYFLOWER RD ROSEDALE, MD 21237 | AFLAC | $21 | — | $21 | 0.09% |
| ERIKA J SHADDOCK3 | 3224 SUMMIT AVE PARKVILLE, MD 21234 | AFLAC | $16 | — | $16 | 0.07% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $5 | — | $5 | 0.02% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $1K | $160 | $1K | 9.09% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $187 | $37 | $224 | 1.47% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $138 | — | $138 | 0.90% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $94 | $37 | $131 | 0.86% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $3 | — | $3 | 0.02% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $1K | — | $1K | 6.90% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $171 | — | $171 | 1.14% |
| JOHN A LECKLITER3 | 2454 BARONSMEDE CT WINTER GARDEN, FL 34787 | AFLAC | $52 | — | $52 | 0.35% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $24 | — | $24 | 0.16% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $5 | — | $5 | 0.03% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $992 | $57 | $1K | 8.28% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $144 | — | $144 | 1.14% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $55 | $13 | $68 | 0.54% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $46 | $13 | $59 | 0.47% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $3 | — | $3 | 0.02% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $942 | $28 | $970 | 7.72% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $162 | — | $162 | 1.29% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $34 | $7 | $41 | 0.33% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $16 | $7 | $23 | 0.18% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $5 | — | $5 | 0.04% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P.O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $595 | $71 | $666 | 5.74% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $68 | $17 | $85 | 0.73% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILE, MD 21108 | AFLAC | $68 | $17 | $85 | 0.73% |
| SHEM J BOSTICK3 | 1620 S DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $75 | — | $75 | 0.65% |
| DALE SHADDOCK3 | 8927 MAYFLOWER ROAD ROSEDALE, MD 21237 | AFLAC | $49 | — | $49 | 0.42% |
| JEREMEY HOELKER3 | 14022 AMYS MEADOW CT LEESBURG, VA 20176 | AFLAC | $48 | — | $48 | 0.41% |
| KELLY J DECKER3 | 25050 RIDING PLZ SUITE 130 401 SOUTH RIDING, VA 20152 | AFLAC | $47 | — | $47 | 0.41% |
| GREER INSURANCE3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILE, MD 21108 | AFLAC | $47 | — | $47 | 0.41% |
| ERIKA J SHADDOCK3 | 3224 SUMMIT AVE PARKVILLE, MD 21234 | AFLAC | $37 | — | $37 | 0.32% |
| LEOPOLD A DYCE JR3 | 128 ISLAND HILL ROAD PALMYRA, VA 22963 | AFLAC | $31 | — | $31 | 0.27% |
| EDWIN VEGA3 | 8214 LEE AVE SEVERN, MD 21144 | AFLAC | $20 | — | $20 | 0.17% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: LEORA M BROWN | 9454 RAITH CT BRISTOW, VA 20136 | AFLAC | $17 | — | $17 | 0.15% |
| DANIEL J LONG3 | 6100 CHEVY CHASE DRIVE SUITE 102 LAUREL, MD 20707 | AFLAC | $8 | — | $8 | 0.07% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $4 | — | $4 | 0.03% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $767 | — | $767 | 8.00% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $95 | — | $95 | 0.99% |
| JOHN A LECKLITER3 | 2454 BARONSMEDE CT WINTER GARDEN, FL 34787 | AFLAC | $87 | — | $87 | 0.91% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $44 | — | $44 | 0.46% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $5 | — | $5 | 0.05% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $520 | — | $520 | 7.87% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $102 | — | $102 | 1.54% |
| DORA BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $92 | — | $92 | 1.39% |
| DAVID MORNINGSTAR3 | 4281 BUCKSKIN WOOD DRIVE ELLICOTT CITY, MD 21042 | AFLAC | $7 | — | $7 | 0.11% |
| JEREMY A FELDMAN3 | 11337 NEWPORT BAY DRIVE BERLIN, MD 21811 | AFLAC | $6 | — | $6 | 0.09% |
| KELLEY LYNN FELDMAN3 | 11337 NEWPORT BAY DRIVE BERLIN, MD 21811 | AFLAC | $3 | — | $3 | 0.05% |
| EDWIN VEGA3 | 8214 LEE AVE SEVERN, MD 21144 | AFLAC | $2 | — | $2 | 0.03% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | PO BOX 982 CLARKSBURG, MD 20871 | AFLAC | $554 | — | $554 | 9.17% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $93 | — | $93 | 1.54% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $355 | — | $355 | 7.32% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $63 | — | $63 | 1.30% |
| ERIKA J SHADDOCK3 | 3224 SUMMIT AVE PARKVILLE, MD 21234 | AFLAC | $15 | — | $15 | 0.31% |
| GREER INSURANCE3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $11 | — | $11 | 0.23% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $8 | — | $8 | 0.16% |
| DALE SHADDOCK3 Filed as: DALE SHADDOCKK | 8927 MAYFLOWER RD ROSEDALE, MD 21237 | AFLAC | $6 | — | $6 | 0.12% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $2 | — | $2 | 0.04% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | PO BOX 982 CLARKSBURG, MD 20871 | AFLAC | $355 | $61 | $416 | 8.83% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MA 20778 | AFLAC | $71 | $14 | $85 | 1.81% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $37 | $14 | $51 | 1.08% |
| SHEM J BOSTICK3 | 1620 S DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $31 | — | $31 | 0.66% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $310 | $68 | $378 | 8.74% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MA 20778 | AFLAC | $71 | $16 | $87 | 2.01% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $43 | $16 | $59 | 1.36% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $23 | — | $23 | 0.53% |
| ERIKA J SHADDOCK3 | 3224 SUMMIT AVE PARKVILLE, MD 21234 | AFLAC | $15 | — | $15 | 0.35% |
| GREER INSURANCE3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $12 | — | $12 | 0.28% |
| DALE SHADDOCK3 | 8927 MAYFLOWER ROAD ROSEDALE, MD 21237 | AFLAC | $6 | — | $6 | 0.14% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $1 | — | $1 | 0.02% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P.O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $317 | $51 | $368 | 8.68% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $46 | — | $46 | 1.08% |
| SARAH A ROBERTSON3 | 5337 SWEETWATER DRIVE WEST RIVER, MD 20778 | AFLAC | $32 | $12 | $44 | 1.04% |
| MATTHEW W EVANS3 | 8370 VETERANS HIGHWAY SUITE 101 MILLERSVILLE, MD 21108 | AFLAC | $17 | $12 | $29 | 0.68% |
| TYGRESSA JONES3 | 9124 LOUGHRAN ROAD FORT WASHINGTON, MD 20744 | AFLAC | $2 | — | $2 | 0.05% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $67 | — | $67 | 9.33% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $11 | — | $11 | 1.53% |
| DAWN JOHNSON3 Filed as: DAWN M JOHNSON | P. O. BOX 982 CLARKSBURG, MD 20871 | AFLAC | $47 | — | $47 | 9.44% |
| SHEM J BOSTICK3 | 1620 S. DITMAR STREET OCEANSIDE, CA 92054 | AFLAC | $7 | — | $7 | 1.41% |
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 | 122 | 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) | 122 | 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. | 111 | $686K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 182 | $68K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 182 | $68K |
| Short-term disability(15 contracts) | AFLAC | 15 | $131K |
| Other(15 contracts) | AFLAC | 15 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.