| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 1800 WEST LOOP SOUTH, SUITE 2115 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $17K | $6K | $23K | 14.66% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST, SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.74% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.58% |
| 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 | $3K | $3K | 2.25% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 1800 WEST LOOP SOUTH, SUITE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $10K | 9.67% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.84% |
| LOCKTON COMPANIES, LLC3 | PO BOX 650823 DALLAS, TX 75265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $192 | $192 | 0.18% |
| CHRISTOPHER T KELLY3 Filed as: CHRISTOPHER T. KELLY | 2040 NORTH LOOP WEST, SUITE 12 HOUSTON, TX 77018 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | $0 | $9K | 11.09% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 4635 SOUTHWEST FREEWAY SUITE 750 HOUSTON, TX 77027 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | $0 | $7K | 9.17% |
| ANA J KELLY3 Filed as: ANA J. KELLY | 2040 NORTH WEST LOOP, SUITE 12 HOUSTON, TX 77018 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.97% |
| JEFFREY M SATTERLEE3 Filed as: JEFFREY M. SATTERLEE | 100 SUN AVENUE NE, SUITE 650 ALBUQUERQUE, NM 87109 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.41% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $892 | $0 | $892 | 1.12% |
| THE BLUE ORANGE SOLUTIONS, LLC3 | 2435 NORTH CENTRAL EXPRESSWAY SUITE 1200 RICHARDSON, TX 75080 | CONTINENTAL AMERICAN INSURANCE COMPANY | $135 | $0 | $135 | 0.17% |
| ROGERS BENEFIT GROUP INC4 Filed as: M ROGERS GROUP, LLC | PO BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 13.48% |
| PATRIOT GROWTH INSURANCE SERVICES4 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 12.56% |
| PATRICIA A. BOLLI4 | PO BOX 603 BURWELL, NE 68823 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $403 | $0 | $403 | 4.38% |
| W. WILLIAM WORNARDT III4 Filed as: W WILLIAM WORNARDT III | 7707 TIBURON TRAIL SUGAR LAND, TX 77479 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $28 | $0 | $28 | 0.30% |
| MARK E SULLIVAN4 Filed as: MARK E. SULLIVAN | 9211 FOREST CREEK DRIVE TOMBALL, TX 77375 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $22 | $0 | $22 | 0.24% |
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 | 203 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 490 | $105K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 490 | $105K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 364 | $155K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 364 | $155K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 364 | $155K |
| Prescription drug | EMPLOYEE HEALTH INSURANCE MANAGEMENT, INC. | 210 | $281K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 364 | $244K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.