| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | — | $58K | $58K | 3.84% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS SERVICE | — | $31K | $31K | 2.08% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DRIVE WASHINGTON, PA 19034 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 3.71% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE | 2677 N MAIN STREET SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 1.18% |
| INTREPID SOLUTIONS INSURANCE3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 4.18% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 7777 CENTER AVENUE HUNTINGTON BEACH, CA 92647 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $5K | $10K | 28.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $596 | $596 | 1.71% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 7777 CENTER AVENUE HUNTINGTON BEACH, CA 92647 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 28.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $504 | $504 | 1.50% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 7777 CENTER AVENUE NEWPORT BEACH, CA 92660 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 28.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $511 | $511 | 1.53% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 7777 CENTER AVENUE HUNTINGTON BEACH, CA 92647 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $4K | $6K | 23.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $435 | $435 | 1.60% |
| INTREPID SOLUTIONS INSURANCE3 | 1500 QUIAIL STREET, SUITE 570 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC. | $450 | — | $450 | 9.19% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 96 | $1.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 234 | $144K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 234 | $139K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $61K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $33K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 96 | $1.9M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.