| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $52K | $0 | $52K | 10.70% |
| USI INSURANCE SERVICES LLC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$25 | $0 | -$25 | -0.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SER | 1900 GRANT ST STE650 DENVER, CO 80203 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | $0 | $13K | 9.85% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SER | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 1.98% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SERVICES L | — | UNITED CONCORDIA INSURANCE COMPANY | $8K | $0 | $8K | 10.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SERVICES L | — | UNITED CONCORDIA INSURANCE COMPANY | $2K | $0 | $2K | 10.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT ST SUITE 650 DENVER, CO 80203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 19.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $819 | $819 | 5.03% |
| JENNIFER BELL3 | 5445 FOX RUN BLVD FREDERICK, CO 80504 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $3K | $0 | $3K | 16.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES L | PO BOX 62889 VIRGINIA BEACH, VA 23466 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 6.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SER | STE 215 501 OFFICE CENTER DR FORT WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $436 | $0 | $436 | 2.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT ST SUITE 650 DENVER, CO 80203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 18.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $682 | $682 | 4.54% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1900 GRANT ST SUITE 650 DENVER, CO 80203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 18.32% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $840 | $840 | 6.32% |
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 | 300 | 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) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 0 | $490K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 270 | $82K |
| Vision | UNITED CONCORDIA INSURANCE COMPANY | 220 | $21K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 306 | $127K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 306 | $127K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 306 | $127K |
| Other(5 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 306 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 306 | — |
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.