| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| N/A3 | — | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $48K | — | $48K | 2.21% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN, DOWIE, CLABBY & MCCAUSLAN | 3022 AIRPORT BLVD PO 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $6K | $893 | $7K | 5.02% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $6K | 15.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $691 | $691 | 1.81% |
| PDCM INSURANCE5 | 3022 AIRPORT BLVD WATERLOO, IA 50702 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 9.99% |
| WELLMARK INC5 Filed as: WELLMARK, INC | 1331 GRAND AVENUE DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $157 | — | $157 | 0.43% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 20.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $657 | $657 | 1.85% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 18.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $613 | $613 | 1.95% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 230 | $2.2M |
| Dental | DELTA DENTAL OF IOWA | 227 | $142K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 199 | $37K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 81 | $31K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 467 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 467 | — |
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.