| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | HEALTH CARE SERVICE CORPORATION | $55K | $2K | $57K | 2.52% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $3K | $17K | 11.80% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.05% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 19.35% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.49% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 20.99% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.42% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $6K | 19.62% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $752 | $752 | 2.64% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $916 | $3K | 14.24% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $524 | $524 | 2.43% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $659 | $3K | 19.10% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $376 | $376 | 2.34% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $866 | $3K | 20.46% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $495 | $495 | 3.12% |
| HOTCHKISS INSURANCE AGENCY LLC3 Filed as: HOTCHKISS INSURANCE AGENCY, LLC | 4120 INTERNATIONAL PKWY STE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $459 | $2K | 19.27% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $262 | $262 | 2.44% |
| HOTCHKISS INSURANCE AGENCY LLC3 | 4120 INTERNATIONAL PKWY SUITE 2000 CARROLLTON, TX 75007 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
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 | 78 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 79 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 357 | $2.2M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $142K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 64 | $22K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $48K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $28K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 57 | $42K |
| Prescription drug | HEALTH CARE SERVICE CORPORATION | 357 | $2.2M |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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.