| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 7855 S RIVER PKWY STE 210 TEMPE, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 5.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 3.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PW 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $741 | $741 | 0.83% |
| KAMIL A BREEDLOVE3 | — | COMBINED INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 12.14% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH SERVICES L | — | COMBINED INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 7.99% |
| MARK METTILLE3 Filed as: MARK WHEELER | — | COMBINED INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.84% |
| ANGELICA SAMANIEGO3 Filed as: ANGELICA OSUNA | — | COMBINED INSURANCE COMPANY OF AMERICA | $992 | $0 | $992 | 1.43% |
| THE JAMES B OSWALD COMPANY3 Filed as: TAYLOR BOWMAN | — | COMBINED INSURANCE COMPANY OF AMERICA | $882 | $0 | $882 | 1.27% |
| SEAN FX GLEASON LLC3 Filed as: SEAN BOUSFIELD | — | COMBINED INSURANCE COMPANY OF AMERICA | $549 | $0 | $549 | 0.79% |
| JEFFERY TAL WEBB3 Filed as: JEFFERY ERICKSON | — | COMBINED INSURANCE COMPANY OF AMERICA | $339 | $0 | $339 | 0.49% |
| ROY QUINONES3 | — | COMBINED INSURANCE COMPANY OF AMERICA | $87 | $0 | $87 | 0.13% |
| JEANNETTE E FATHERREE3 Filed as: JEANNETTE DURRANI | — | COMBINED INSURANCE COMPANY OF AMERICA | $40 | $0 | $40 | 0.06% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 7855 S RIVER PKWY STE 210 SUITE 210 TEMPE, AZ 85284 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 20.03% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOC INC | 3800 N CENTRAL AVE FL 9 PHOENIX, AZ 85012 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PW 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $860 | $860 | 2.24% |
| 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 | 285 | 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) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 176 | $89K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 55 | $38K |
| Other(3 contracts, 3 carriers) | COMBINED INSURANCE COMPANY OF AMERICA | 107 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.