| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 7855 S RIVER PKWY SUITE 210 TEMPE, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH SERVICES L | — | COMBINED INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 8.04% |
| KAMIL A BREEDLOVE3 | — | COMBINED INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.62% |
| MARK METTILLE3 Filed as: MARK WHEELER | — | COMBINED INSURANCE COMPANY OF AMERICA | $629 | $0 | $629 | 0.86% |
| SEAN FX GLEASON LLC3 Filed as: SEAN BOUSFIELD | — | COMBINED INSURANCE COMPANY OF AMERICA | $603 | $0 | $603 | 0.82% |
| RAUL CAIRO JR3 Filed as: RAUL X MEDINA | — | COMBINED INSURANCE COMPANY OF AMERICA | $467 | $0 | $467 | 0.64% |
| JEANNETTE E FATHERREE3 Filed as: JEANNETTE DURRANI | — | COMBINED INSURANCE COMPANY OF AMERICA | $301 | $0 | $301 | 0.41% |
| ANGELICA SAMANIEGO3 Filed as: ANGELICA OSUNA | — | COMBINED INSURANCE COMPANY OF AMERICA | $208 | $0 | $208 | 0.28% |
| KATHRYN SUZANNE AXENTE3 Filed as: KATHRYN HUMPHRY'S | — | COMBINED INSURANCE COMPANY OF AMERICA | $110 | $0 | $110 | 0.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 7855 S RIVER PKWY SUITE 210 FORT WASHINGTON, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 7855 S RIVER PKWY STE 210 TEMPE, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $396 | $396 | 3.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 7855 S RIVER PKWY SUITE 210 TEMPE, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD AND ASSOCIATES INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $552 | $552 | 5.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 501 OFFICE CENTER DR SUITE 215 FORT WASHINGTON, PA 19034 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 43.42% |
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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $89K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $51K |
| Other(4 contracts, 3 carriers) | COMBINED INSURANCE COMPANY OF AMERICA | 282 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 282 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
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.