| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | BLUE CROSS OF CALIFORNIA | $65K | $0 | $65K | 5.28% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | $0 | $18K | 5.01% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | PO BOX 750004 PETALUMA, CA 94975 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 12.77% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | PO BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $3K | $0 | $3K | 10.02% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | VISION SERVICE PLAN | $685 | $0 | $685 | 2.50% |
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 | 155 | 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) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 241 | $1.6M |
| Dental | BLUE CROSS OF CALIFORNIA | 241 | $1.2M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 241 | $1.3M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 155 | $39K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 155 | $39K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 241 | $1.6M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 155 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.