| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE WASHINGTON, PA 19034 | BLUE CROSS OF CALIFORNIA | $162K | — | $162K | 5.37% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | BLUE CROSS OF CALIFORNIA | — | $60K | $60K | 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 | $12K | $8K | $20K | 25.19% |
| FMLASOURCE INC3 Filed as: FMLASOURCE INC. | 455 N CITYFRONT PLZ DR CHIGAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 7.87% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $6K | $15K | 25.08% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 25.33% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 25.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 25.03% |
| VOLUNTARY BENEFITS SPECIALISTS LLC3 Filed as: VOLUNTARY BENEFITS SPECIALISTS | 289 FARRIS AVENUE LAS VEGAS, NV 89183 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | — | $5K | 27.28% |
| ROGERS BENEFIT GROUP INC3 Filed as: MELINDA ROGERS | P.O. BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 16.17% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 15.40% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 257 | $3.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 257 | $3.0M |
| Vision | BLUE CROSS OF CALIFORNIA | 257 | $3.0M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 257 | $3.1M |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 72 | $80K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 240 | $61K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 257 | $3.0M |
| Other(6 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 257 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.