| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC LLC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | $35K | — | $35K | 6.67% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | $27K | — | $27K | 5.29% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC LLC | 2106 CAHABA ROAD MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | $23K | — | $23K | 4.46% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $12K | $12K | 2.40% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC LLC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $12K | $12K | 2.32% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC LLC | 2106 CAHABA ROAD MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $8K | $8K | 1.62% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | $6K | — | $6K | 1.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | $0 | $4K | $4K | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 51 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $3K | $3K | 0.66% |
| UNITED OF OMAHA LIFE INSURANCE CO5 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $3K | $3K | 0.65% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC | 2106 CAHABA ROAD SUITE B MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $3K | $3K | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $2K | $2K | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $803 | $803 | 0.16% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVC LLC | 2106 CAHABA ROAD MOUNTAIN BROOK, AL 35223 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $249 | $249 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $71 | $71 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 ADMINISTRATOR | Claims processing Service code 12 | 450 RIVERCHASE PARKWAY EAST BIRMINGHAM, AL 35298 | $421K |
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 | 472 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 472 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MUTUAL OF OMAHA INSURANCE COMPANY | 533 | $517K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 533 | $517K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 533 | $517K |
| Stop-loss / reinsurancereinsurance | SIRIUSPOINT AMERICA INSURANCE COMPANY | 472 | $1.2M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 533 | $517K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 533 | — |
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.