| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 400 INTERSTATE N PKWY STE 300 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $22K | $7K | $28K | 12.95% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS | 1781 SHARP SPRINGS RD WINCHESTER, TN 37398 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.84% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 1 | $6K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.