| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 9.92% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA DENTAL HEALTH OF COLORADO, INC. | $765 | — | $765 | 9.99% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 1900 NORTH GRANT STREET SUITE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $947 | $339 | $1K | 20.37% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $65 | $65 | 1.03% |
| ROGERS BENEFIT GROUP INC3 Filed as: MICHAEL J ROGERS | PO BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES INC DBA LEAGALSHIELD | $2K | — | $2K | 27.29% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES INC DBA LEAGALSHIELD | $1K | — | $1K | 19.18% |
| LYNN R LIONHOOD3 | 140 POND VIEW DRIVE WATER TOWN, CT 06795 | PRE-PAID LEGAL SERVICES INC DBA LEAGALSHIELD | $30 | — | $30 | 0.53% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 1900 NORTH GRANT STREET SUITE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $452 | $131 | $583 | 25.82% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $25 | $25 | 1.11% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 1900 NORTH GRANT STREET SUITE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $311 | $168 | $479 | 23.10% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $32 | $32 | 1.54% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $24 | — | $24 | 10.13% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA DENTAL HEALTH OF TEXAS, INC. | $18 | — | $18 | 9.89% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $17 | — | $17 | 10.12% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT STREET SUITE 650 DENVER, CO 80203 | CIGNA DENTAL HEALTH OF NEW MEXICO, INC. | $6 | — | $6 | 10.71% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(6 contracts, 6 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 102 | $48K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 102 | $39K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $4K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $6K |
| Other(3 contracts, 2 carriers) | PRE-PAID LEGAL SERVICES INC DBA LEAGALSHIELD | 124 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.