| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 1465 N MCDOWELL BLVD SUITE 180 PETALUMA, CA 88382 | UNITEDHEALTHCARE INSURANCE COMPANY | $68K | $0 | $68K | 3.87% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 2251 DOUGLAS BLVD SUITE 115 ROSEVILLE, CA 91446 | UNITEDHEALTHCARE INSURANCE COMPANY | $23K | $0 | $23K | 1.30% |
| SSM INSURANCE SERVICES, INC.3 | PO BOX 750004 PETALUMA, CA 94971 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $0 | $13K | 0.73% |
| SSM INSURANCE SERVICES, INC.3 | ONE WILLOWBROOK COURT, SUITE 230 PETALUMA, CA 94954 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $500 | $0 | $500 | 10.99% |
| ALTERITY BROKER SOLUTIONS3 Filed as: ALTERITY BROKER SOLUTIONS, INC. | 8777 N GAINEY CENTER DR. SUITE 260 SCOTTSDALE, AZ 85258 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $227 | $0 | $227 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES ADMINISTRATOR | Contract Administrator Service code 13 | 1465 N MCDOWELL BLVD SUITE 180 PETALUMA, CA 88382 | $69K |
| ROGERS BENEFIT GROUP INC CA ADMINISTRATOR | Contract Administrator Service code 13 | 5110 N 40TH ST SUITE 234 PHOENIX, AZ 82867 | $23K |
| SSM INSURNACE SERVICES, INC ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 750004 PETALUMA, CA 94971 | $13K |
| ALTERITY BROKER SOLUTIONS, INC. ADMINISTRATOR | Contract Administrator Service code 13 | 8777 N GAINEY CENTER DR. SUITE 260 SCOTTSDALE, AZ 85258 | $512 |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 288 | $1.8M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $5K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.