| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERVICES DBA | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $63 | $8K | 3.03% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1800 WEST LOOP S SUITE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.51% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | METROPOLITAN LIFE INSURANCE COMPANY | $607 | $0 | $607 | 0.22% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | $2K | $6K | 25.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $2K | $2K | 7.87% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC. | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $1K | $1K | 6.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | UNITED OF OMAHA LIFE INSURANCE CO | $2K | $920 | $3K | 23.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $736 | $736 | 6.76% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC. | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $653 | $653 | 6.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | UNITED OF OMAHA LIFE INSURANCE CO | $2K | $892 | $2K | 23.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $714 | $714 | 6.89% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC. | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $621 | $621 | 6.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | UNITED OF OMAHA LIFE INSURANCE CO | $745 | $489 | $1K | 22.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $392 | $392 | 6.99% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS INC. | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | UNITED OF OMAHA LIFE INSURANCE CO | $0 | $336 | $336 | 5.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PATRIOT GROWTH INS DBA ARROW BEN ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 750004 PETALUMA, CA 94975 | $12K |
| NFP NATIONAL ACCOUNT SERVICES DBA A ADMINISTRATOR | Contract Administrator Service code 13 | 8777 N GAINEY CENTER DR, SUITE 260 SCOTTSDALE, AZ 85258 | $8K |
| PATRIOT GROWTH INS DBA ADVANTAGE ADMINISTRATOR | Contract Administrator Service code 13 | 1800 WEST LOOP S SUITE 2115 HOUSTON, TX 77027 | $4K |
| GI GEORGE PARENT LP ADMINISTRATOR | Contract Administrator Service code 13 | 501 OFFICE CETNER DR SUITE 21T FORT WASHINGTON, PA 19034 | $4K |
| ALTERITY BROKER SOLUTIONS ADMINISTRATOR | Contract Administrator Service code 13 | 8777 N GAINEY CENTER DR SUITE 25 SCOTTSDALE, AZ 85258 | $3K |
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 | 309 | 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) | 309 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 186 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 610 | $276K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 610 | $276K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE CO | 309 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 117 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 63 | $6K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 186 | $1.7M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO | 300 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
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.