| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE OFFICE OF AMERICA3 | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | HEALTH OPTIONS | $30K | $0 | $30K | 4.78% |
| INSURANCES OFFICE OF AMERICA3 | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | BLUE CROSS BLUE SHIELD OF FLORIDA | $6K | $0 | $6K | 4.66% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA IN | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 8.04% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 2056 VISTA PKWY SUITE 350 WEST PALM BEACH, FM 33411 | SUN LIFE ASSURANCE COMPANY OF CANADA | $426 | $0 | $426 | 1.80% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $482 | $0 | $482 | 8.11% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $112 | $0 | $112 | 1.88% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $454 | $0 | $454 | 8.14% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $104 | $0 | $104 | 1.86% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $342 | $0 | $342 | 8.25% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LL | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $72 | $0 | $72 | 1.74% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $328 | $0 | $328 | 7.98% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $83 | $0 | $83 | 2.02% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $612 | $0 | $612 | 16.06% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $150 | $0 | $150 | 3.94% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 2056 VISTA PKWY STE 350 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $202 | $0 | $202 | 8.28% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 2056 VISTA PKWY STE 305 WEST PALM BEACH, FL 33411 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $42 | $0 | $42 | 1.72% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 62 | $744K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 57 | $24K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 57 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $6K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 62 | $744K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.