| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 800 MAIN ST DUBUQUE, IA 52001 | AETNA LIFE INSURANCE CO. | $18K | $0 | $18K | 1.71% |
| VARNEY & COMPANY BENEFITS ADVISORS3 Filed as: VARNEY & CO. BENEFITS ADVISORS | 32 OAK STREET BANGOR, ME 04401 | AETNA LIFE INSURANCE CO. | $18K | $0 | $18K | 1.66% |
| DAVID KELLER3 Filed as: DAVID M. KELLER | 755 OAKHILL RD MOUNTAIN TOP, PA 18707 | HIGHMARK INC. | $4K | — | $4K | 0.59% |
| VARNEY & COMPANY BENEFITS ADVISORS3 | LLC 383 US ROUTE 1 STE 1E SCARBOROUGH, ME 04074 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.55% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | — | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.44% |
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 | 262 | 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) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 264 | $1.8M |
| Dental | AETNA LIFE INSURANCE CO. | 264 | $1.1M |
| Vision | AETNA LIFE INSURANCE CO. | 264 | $1.1M |
| Life insurance | STANDARD INSURANCE COMPANY | 271 | $118K |
| Short-term disability | STANDARD INSURANCE COMPANY | 271 | $118K |
| Long-term disability | STANDARD INSURANCE COMPANY | 271 | $118K |
| Other | STANDARD INSURANCE COMPANY | 271 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 271 | — |
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.