| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTREPID3 Filed as: INTREPID BENEFITS INC | 1900 N GRANT ST STE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $701 | $3K | 4.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 1900 N GRANT ST STE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $925 | $0 | $925 | 1.45% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $802 | $802 | 1.26% |
| INTREPID3 Filed as: INTREPID BENEFITS INC | 1900 N GRANT ST STE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $407 | $1K | 6.75% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 1900 N GRANT ST STE 650 DENVER, CO 80203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.19% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $233 | $233 | 1.11% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR STE 215 FT. WASHINGTON, PA 19034 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE CO | $855 | $0 | $855 | 9.95% |
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 | 172 | 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) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $64K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE CO | 151 | $9K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.