| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $15K | — | $15K | 1.40% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $9K | — | $9K | 0.79% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | — | $20K | 6.26% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 4.47% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 6.48% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 4.32% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 9.53% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 6.40% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 7.70% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.98% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 7.45% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 6.18% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 9.79% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.31% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.12% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.46% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $609 | — | $609 | 5.98% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $452 | — | $452 | 4.44% |
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 | 1,362 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 1,079 | $100K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,350 | $205K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,011 | $318K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,350 | $210K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 300 | $1.1M |
| Other(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,350 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,350 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.