| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | DELTA DENTAL OF SOUTH DAKOTA | $5K | — | $5K | 5.00% |
| PARTNERS HEALTH INSURANCE3 | 122 CENTRAL AVE SW ORANGE CITY, IA 51041 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 15.00% |
| PARTNERS HEALTH INSURANCE3 Filed as: PARTNERS HEALTH | 122 CENTRAL AVENUE, SW ORANGE CITY, IA 51041 | AVESIS ESSENTIAL BENEFITS | $3K | — | $3K | 11.48% |
| SELECT NETWORKS3 | 6165 NW 86TH ST., STE 108 JOHNSTON, IA 50131 | AVESIS ESSENTIAL BENEFITS | $425 | — | $425 | 1.67% |
| WELLMARK INC3 Filed as: WELLMARK, INC | 1331 GRAND AVENUE DES MOINES, IA 50309 | AVESIS ESSENTIAL BENEFITS | $119 | — | $119 | 0.47% |
| PARTNERS HEALTH INSURANCE3 | 122 CENTRAL AVE SW ORANGE CITY, IA 51041 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $783 | — | $783 | 10.00% |
| PARTNERS HEALTH INSURANCE3 | 122 CENTRAL AVE SW ORANGE CITY, IA 51041 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $251 | — | $251 | 9.99% |
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 | 328 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK OF SOUTH DAKOTA, INC | 193 | $1.7M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 318 | $92K |
| Vision | AVESIS ESSENTIAL BENEFITS | 300 | $26K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 490 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 328 | $66K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 328 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.