| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 WEST OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | CAREFIRST BLUE CHOICE, INC. | $51K | $8K | $58K | 6.24% |
| EMPLOYEE BENEFITS CORP OF AMERICA5 Filed as: EMPLOYEE BENEFITS CORP AMERICA | 1410 SPRING HILL ROAD, SUITE 150 MCLEAN, VA 22102 | CAREFIRST BLUE CHOICE, INC. | $0 | $5K | $5K | 0.58% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD FAIRFAX, VA 22030 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $7K | $16K | 19.03% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD FAIRFAX, VA 22030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 16.30% |
| DJA, INC.3 | 4069 CHAIN BRIDGE ROAD FAIRFAX, VA 22030 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.60% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.37% |
| AMWINS5 | 11350 MCCORMICK ROAD, SUITE 400 HUNT VALLEY, MD 21031 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 WEST OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.93% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUE CHOICE, INC. | 137 | $937K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 66 | $82K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 66 | $82K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $70K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $70K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $70K |
| Prescription drug | CAREFIRST BLUE CHOICE, INC. | 137 | $937K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 97 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.