| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCES SVCS LLC | SAFEGUARD GROUP 100 GRANITE DRIVE, SUITE 205 MEDIA, PA 19063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.84% |
| SAFEGUARD GROUP INC3 Filed as: THE SAFEGUARD GROUP INC | 100 GRANITE DRIVE, SUITE 205 MEDIA, PA 19063 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.71% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 Filed as: JAMES R NELLIGAN AND ASSOCIATES LLC | 1933 STATE ROUTE 35, SUITE 368 WALL TOWNSHIP, NJ 07719 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $240 | $240 | 0.39% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 100 GRANITE DRIVE SUITE 109 MEDIA, PA 19063 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 6.28% |
| MAZZMAR LLC3 | 1767 SENTRY PKWY W BLUE BELL, PA 194222219 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16 | $0 | $16 | 0.03% |
| INDEPENDENCE PLANNING GROUP3 | 1767 SENTRY PKWY W BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3 | $0 | $3 | 0.01% |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SWISS RE CORPORATE SOLUTIONS AMERICA INS. CORP. | 80 | $234K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 78 | $51K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 78 | $51K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $61K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $61K |
| Stop-loss / reinsurancereinsurance | SWISS RE CORPORATE SOLUTIONS AMERICA INS. CORP. | 80 | $234K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 104 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 104 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.