| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $14K | $14K | 3.14% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 6929 N HAYDEN RD STE C-4454 SCOTTSDALE, AZ 85250 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $9K | $9K | 2.12% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 6929 N HAYDEN RD STE C4454 SCOTTSDALE, AZ 85250 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | — | $5K | 13.66% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 E DOUBLETREE RANCH RD STE C-103 SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 3.94% |
| DIGITAL INSURANCE LLC3 | 300 GALLERIA PKWY STE 1100 ATLANTA, GA 30339 | TRANSAMERICA LIFE INSURANCE COMPANY | $242 | — | $242 | 0.71% |
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $413 | $2K | 5.23% |
| 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 | — | $825 | $825 | 2.43% |
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $251 | $1K | 10.84% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $751 | — | $751 | 6.25% |
| 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 | — | $251 | $251 | 2.09% |
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $799 | $209 | $1K | 11.20% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $550 | — | $550 | 6.11% |
| 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 | — | $209 | $209 | 2.32% |
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP, LLC | 21803 N SCOTTSDALE RD STE 240 SCOTTSDALE, AZ 85255 | AVESIS INSURANCE INCORPORATED | $567 | — | $567 | 7.74% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | — | AVESIS INSURANCE INCORPORATED | $174 | — | $174 | 2.37% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $685 | — | $685 | 11.96% |
| BRIDGEMARK INSURANCE GROUP3 Filed as: BRIDGEMARK INSURANCE GROUP LLC | 6929 N HAYDEN RD STE C4-454 SCOTTSDALE, AZ 85250 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $175 | $435 | $610 | 10.65% |
| 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 | — | $435 | $435 | 7.59% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 72 | $445K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 58 | $34K |
| Vision | AVESIS INSURANCE INCORPORATED | 65 | $7K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 28 | $12K |
| Other(3 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 100 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.