| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | BLUECROSS BLUESHIELD OF ILLINOIS | $37K | $1K | $38K | 3.16% |
| FIDUCIAL0 | PO BOX 192443201 OLD JACKSONVILLE R SPRINGFIELD, IL 627119201 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $1 | $1 | 0.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES IN | PO BOX 28 DUBUQUE, IA 520040028 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $7K | 7.86% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | 800 MAIN ST DUBUQUE, IA 52001 | MUTUAL OF OMAHA INSURANCE COMPANY | $9K | $3K | $12K | 17.86% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | DEARBORN LIFE INSURANCE COMPANY | $4K | $377 | $4K | 10.89% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 520040028 | EYEMED VISION CARE | $2K | — | $2K | 12.16% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | PO BOX 28 DUBUQUE, IA 52004 | METLIFE LEGAL PLANS | $185 | $130 | $315 | 17.05% |
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 | 170 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 151 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 167 | $85K |
| Vision | EYEMED VISION CARE | 278 | $14K |
| Life insurance(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 157 | $101K |
| Long-term disability(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 157 | $101K |
| Other(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 157 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 278 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.