| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| N/A3 | — | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $45K | $0 | $45K | 1.80% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN, DOWIE, CLABBY, MCCAUSLAND | 3022 AIRPORT BLVD WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $6K | $890 | $7K | 5.15% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN, DOWIE, CLABBY, MCCAUSLAND | PO BOX 2597 WATERLOO, IA 50701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.28% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR. STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $675 | $675 | 2.08% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN, DOWIE, CLABBY, MCCAUSLAND | PO BOX 2597 WATERLOO, IA 50701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 15.59% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR. STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $639 | $639 | 1.97% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN, DOWIE, CLABBY, MCCAUSLAND | PO BOX 2597 WATERLOO, IA 50701 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.75% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE COMPANY | 501 OFFICE CENTER DR. STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $666 | $666 | 2.17% |
| SELECT NETWORKS3 | 317 6TH AVE STE. 1440 DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 11.00% |
| PDCM INSURANCE3 | 3022 AIRPORT BLVD WATERLOO, IA 50702 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| GROUP BENEFITS DESIGN CORPORATION3 | 3022 AIRPORT BLVD WATERLOO, IA 50703 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 20.00% |
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 | 220 | 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) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 211 | $2.5M |
| Dental | DELTA DENTAL OF IOWA | 213 | $134K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 280 | $30K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 458 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 86 | $32K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 458 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.