| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 4069 CHAIN BRIDGE ROAD TOP FLOOR FAIRFAX, VA 22030 | PRINCIPAL LIFE INSURANCE COMPANY | $41K | $6K | $48K | 14.06% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 5420 LYNDON B JOHNSON FREEWAY, SUITE 600 DALLAS, TX 75240 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $23K | $35K | 10.18% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $23K | $23K | 6.69% |
| ROGERS BENEFIT GROUP INC4 Filed as: M ROGERS GROUP, LLC | PO BOX 853 GEORGETOWN, CO 80444 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 25.84% |
| PATRIOT GROWTH INSURANCE SERVICES4 | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 25.37% |
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 | 221 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $12K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $339K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $339K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $339K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $339K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $339K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 327 | $346K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.