| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $691 | $3K | 19.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT P | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $307 | $307 | 1.86% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT INSURANCE SVCS LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $594 | $3K | 24.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $264 | $264 | 1.93% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 31.27% |
| ROGERS BENEFIT GROUP INC4 Filed as: M ROGERS GROUP | — | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $619 | — | $619 | 14.87% |
| PATRIOT GROWTH INSURANCE SERVICES4 Filed as: PATRIOT GROWTH INSURANCE SER | — | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $385 | — | $385 | 9.25% |
| INSGROUP INC3 Filed as: PATRIOT INSURANCE GROUP SVCS LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $368 | $149 | $517 | 14.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $66 | $66 | 1.79% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT INSURANCE SVCS LLC | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | $322 | $96 | $418 | 18.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT P | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $42 | $42 | 1.90% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 78 | $10K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $4K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $2K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $17K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 97 | — |
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.