| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 20.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 20.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.45% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.65% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVS INC | 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $729 | $0 | $729 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUN LIFE ASSURANCE CO NONE | Claims processing Service code 12 | ONE SUN LIFE EXECUTIVE PARK, SC4399 WELLESLEY HILLS, MA 02481 | $553K |
| SISCO EIN 42-1144827 NONE | Claims processing Service code 12 | — | $130K |
| OPTUMHEALTH MTP - UHIC EIN 52-1996029 NONE | Claims processing Service code 12 | — | $22K |
| WPPA EIN 48-0959093 NONE | Claims processing Service code 12 | — | $14K |
| CIGNA EIN 59-1031071 NONE | Claims processing Service code 12 | — | $11K |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 157 | $21K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 72 | $37K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 139 | $22K |
| Stop-loss / reinsurancereinsurance | SELF INSURED SERVICES COMPANY (SISCO) | 161 | $553K |
| Other(5 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 157 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.