| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 WEST OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | CALIFORNIA CHOICE | $51K | $0 | $51K | 5.00% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 12222 MERIT DRIVE, SUITE 1780 DALLAS, TX 75251 | CALIFORNIA CHOICE | $16K | $0 | $16K | 1.55% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 1465 NORTH MCDOWELL BOULEVARD SUITE 180 PETALUMA, CA 94954 | PRINCIPAL LIFE INSURANCE COMPANY | $20K | $13K | $33K | 16.67% |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 97 | $1.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Prescription drug | CALIFORNIA CHOICE | 97 | $1.0M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.