| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES, INC. | 1445 RESEARCH BLVD, SUITE 340 ROCKVILLE, MD 20850 | BENISTAR GROUP RETIRE HEALTH SOLUTIONS | $16K | $0 | $16K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-ATLANTIC INC. | 3290 N RIDGE RD #300 ELLICOTT CITY, MD 21043 | GUARDIAN | $0 | $3K | $3K | 5.02% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 12404 PARK CENTRAL DRIVE, # 400S DALLAS, TX 75251 | GUARDIAN | $2K | $0 | $2K | 2.96% |
| RAFFA & ASSOC FINANCIAL SVCS, INC.3 Filed as: RAFFA FINANCIAL SERVICES, INC. | 1445 RESEARCH BLVD, SUITE 340 ROCKVILLE, MD 20850 | HARTFORD LIFE AND ACCIDENT | $128 | $0 | $128 | 14.95% |
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 | 87 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 87 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 49 | $751K |
| Dental | DELTA DENTAL INSURANCE COMPANY | 87 | $47K |
| Vision | NATIONAL VISION ADMINISTRATION, L.L.C. | 59 | $4K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 51 | $64K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 51 | $64K |
| Long-term disability | GUARDIAN | 37 | $63K |
| Other | GUARDIAN | 37 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 87 | — |
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."
No prospect flags tripped on this filing.