| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA THE OLSON GROUP | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | AMERITAS LIFE INSURANCE CORP | $11K | $2K | $13K | 11.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FT WASHINGTON, PA 19034 | AMERITAS LIFE INSURANCE CORP | $0 | $3K | $3K | 2.49% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA THE OLSON GROUP | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 7.36% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA THE OLSON GROUP | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | STANDARD INSURANCE COMPANY | $8K | $1K | $9K | 22.29% |
| BHERD3 | 1956 PARK AVE DES MOINES, IA 50315 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 3.16% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA THE OLSON GROUP | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 7.22% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA THE OLSON GROUP | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $985 | — | $985 | 7.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGIONAL CARE INC EIN 47-0760050 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | $55K |
| PATRIOT GROWTH INSURANCE SVCS LLC EIN 83-1217761 BROKER | Insurance agents and brokers Service code 22 | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | $25K |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 319 | $111K |
| Vision | AMERITAS LIFE INSURANCE CORP | 319 | $111K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $74K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 22 | $32K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $45K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 192 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.