| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS., LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | ANTHEM BLUE CROSS | $40K | $0 | $40K | 3.63% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS., LLC | 500 SILVER SPUR ROAD, SUITE 121 PALOS VERDES, CA 90275 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 3.19% |
| BROWN AND BROWN OF FLORIDA, INC.3 | 1201 WEST CYPRESS CREEK ROAD SUITE 130 FORT LAUDERDALE, FL 33309 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.83% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS, LLC | 480 NORTH INDIAN HILL BOULEVARD SUITE 2A CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $87 | $0 | $87 | 0.06% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS., LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLING HILLS ESTATES, CA 90275 | MUTUAL OF OMAHA INSURANCE COMPANY | $5K | $3K | $7K | 15.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTRAL DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $1K | $1K | 2.42% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS., LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLING HILLS ESTATES, CA 90275 | COMPANION LIFE INSURANCE COMPANY | $877 | $488 | $1K | 15.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTRAL DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | COMPANION LIFE INSURANCE COMPANY | $0 | $217 | $217 | 2.47% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS | 131 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 89 | $137K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 89 | $137K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 104 | $57K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 104 | $48K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 104 | $48K |
| Prescription drug | ANTHEM BLUE CROSS | 131 | $1.1M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 104 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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."
No prospect flags tripped on this filing.