| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS. SERVICES | PO BOX 28 DUBUQUE, IA 52004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | $3K | $23K | 13.28% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON, INC. | 300 SOUTH STATE STREET, SUITE 1000 SYRACUSE, NY 13202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 3.73% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS. SERVICES | PO BOX 28 DUBUQUE, IA 52004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $2K | $6K | 6.45% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON, INC. | 300 SOUTH STATE STREET, SUITE 1000 SYRACUSE, NY 13202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $0 | $5K | 4.98% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS. SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | DEARBORN LIFE INSURANCE COMPANY | $5K | $1K | $7K | 15.44% |
| ACRISURE LLC3 Filed as: HAYLOR, FREYER & COON, INC. | 300 SOUTH STATE STREET, SUITE 1000 SYRACUSE, NY 13202 | DEARBORN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.60% |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 148 | $170K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 148 | $170K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 209 | $42K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $91K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 148 | $170K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 209 | $212K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.