| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEALTH PARTNER GROUP LLC3 | 187000 N HAYDEN RD STE 405 SCOTTSDALE, AZ 85255 | SYMETRA LIFE INSURANCE COMPANY | — | $40K | $40K | 7.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SRVCS | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | DELTA DENTAL OF OHIO | $7K | — | $7K | 5.99% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SRVCS | 424 WARDS CORNER RD STE 120 LOVELAND, OH 45140 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 19.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $981 | $981 | 1.81% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SRVCS | 424 WARDS CORNER RD STE 129 LOVELAND, OH 45140 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $832 | $3K | 19.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $303 | $303 | 1.81% |
| STRATEGIC BENEFITS OF CINCINNATI3 Filed as: STRATEGIC BENEFITS OF CINTI | 424 WARDS CORNER RD STTE 120 LOVELAND, OH 45140 | FIDELITY SECURITY LIFE INSURANCE | $2K | — | $2K | 12.05% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SRVCS | 424 WARDS CORNER RD STE 120 LOVELAND, OH 45140 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $398 | $2K | 20.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $145 | $145 | 1.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUSTOM DESIGN BENEFITS, LLC EIN 81-0798821 CLAIMS PROCESSING | Claims processing Service code 12 | — | $71K |
| STRATEGIC EMPLOYEE BENEFITS EIN 31-1127135 BROKER | Insurance agents and brokers Service code 22 | — | $39K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 PPO PROVIDER | Insurance services Service code 23 | — | $10K |
| RX RESULTS EIN 26-3233073 RX AUTHORIZATION | Claims processing Service code 12 | — | $7K |
| PAYER COMPASS EIN 46-2047081 CLAIMS REPRICER | Claims processing Service code 12 | — | $3K |
| CURALINC OTHER | Other services Service code 49 | 314 W SUPERIOR ST 601 CHICAGO, IL 60654 | $3K |
| THE PHIA GROUP EIN 46-1439866 OTHER | Other services Service code 49 | — | $2K |
| KROGER OTHER | Other services Service code 49 | 1014 VINE ST CINCINNATI, OH 45202 | $2K |
| MULTIPLAN, INC OTHER | Other services Service code 49 | 115 5TH AVE FL 7 NEW YORK, NY 10003 | $105 |
| ZELIS (GLOBAL CARE) OTHER | Other services Service code 49 | 149 NEWBURY ST, 5TH FL BOSTON, MA 02116 | $83 |
| COMMONWEALTH OF MA OTHER | Other services Service code 49 | 1 ASHBUTON PLACE BOSTON, MA 02108 | $23 |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 317 | $122K |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 109 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $25K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $54K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 130 | $566K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.