| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | KAISER FOUNDATION HEALTH PLAN, INC. | $62K | $0 | $62K | 3.70% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | CALIFORNIA PHYSICIANS SERVICE | $0 | $49K | $49K | 3.07% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1465 NORTH MCDOWELL BOULEVARD SUITE 180 PETALUMA, CA 94954 | PRINCIPAL LIFE INSURANCE COMPANY | $49K | $12K | $60K | 11.23% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS. AND FIN. SVCS | PO BOX 664173 DALLAS, TX 75266 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $24K | $24K | 4.53% |
| TOTALIS BENEFITS3 Filed as: TOTALIS BENEFITS, INC. | 8777 NORTH GAINEY CENTER DRIVE SUITE 260 SCOTTSDALE, AZ 85258 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $205 | $205 | 0.04% |
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 | 253 | 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) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 203 | $3.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 203 | $3.3M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 472 | $538K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 472 | — |
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.