| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE WASHINGTON, PA 19034 | BLUE CROSS OF CALIFORNIA | $136K | — | $136K | 5.49% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE CROSS OF CALIFORNIA | — | $49K | $49K | 1.97% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURACE | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $11K | $25K | 28.03% |
| FMLASOURCE INC3 Filed as: FMLASOURCE INC. | 455 N CITYFRONT PLZ DR CHIGAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 5.74% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $8K | $17K | 27.21% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $7K | $14K | 32.47% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 29.86% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 27.20% |
| VOLUNTARY BENEFITS SPECIALISTS LLC3 Filed as: VOLUNTARY BENEFITS SPECIALISTS | 289 FARRIS AVENUE LAS VEGAS, NV 89183 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 24.66% |
| ROGERS BENEFIT GROUP INC3 Filed as: MICHAEL J ROGERS | P.O. BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 7.55% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 7.31% |
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 | 300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 300 | $2.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 300 | $2.5M |
| Vision | BLUE CROSS OF CALIFORNIA | 300 | $2.5M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 300 | $2.5M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 95 | $88K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 303 | $64K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 300 | $2.5M |
| Other(6 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 300 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.