| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $36K | $0 | $36K | 2.02% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 500 SILVER SPUR ROAD, SUITE 121 PALOS VERDES, CA 90275 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $36K | $0 | $36K | 1.98% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | $0 | $5K | 2.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | $0 | $4K | 2.09% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 500 SILVER SPUR ROAD, SUITE 121 PALOS VERDES, CA 90275 | CALIFORNIA PHYSICIANS' SERVICE | $9K | $0 | $9K | 5.03% |
| USI INSURANCE SERVICES LLC3 | 630 WEST GERMANTOWN PIKE, SUITE 20 PLYMOUTH MEETING, PA 19462 | CALIFORNIA PHYSICIANS' SERVICE | $9K | $0 | $9K | 4.97% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLNG HILLS ESTATE, CA 90275 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $8K | $17K | 9.28% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 4.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT, LP | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.97% |
| PATRIOT GROWTH INSURANCE SERVICES5 Filed as: PATRIOT GROWTH INS. SERVICES, LLC | 500 SILVER SPUR ROAD, SUITE 121 ROLLING HILLS ESTATE, CA 90275 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.83% |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 136 | $2.0M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 513 | $188K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 513 | $188K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $182K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $182K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $182K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 136 | $2.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 248 | $182K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 513 | — |
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.