| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 511064647 | UNITED HEALTHCARE INSURANCE COMPANY | $9K | $12K | $21K | 1.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 E CARMEL DRIVE STE. 400 CARMEL, IN 46032 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | $12K | $24K | 20.30% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: WELLMARK BLUE CROSS BLUE SHIELD | 1331 GRAND AVENUE DES MOINES, IA 50309 | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | $3K | — | $3K | 3.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 6967 S RIVER GATE DR MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $4K | $8K | 20.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 4200 CORPORATE DRIVE, STE 160 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 12.83% |
| INNOVATIVE BENEFIT CONSULTANTS3 | 412 WATER STREET SIOUX CITY, IA 51103 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $605 | — | $605 | 2.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 6967 S RIVER GATE DR MIDVALE, UT 84047 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $2K | $5K | 20.71% |
| SELECT NETWORKS3 | 317 6TH AVE., SUITE 1040 DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 11.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1 W 4TH ST., STE 109 CINCINNATI, OH 45202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.91% |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 210 | $1.4M |
| Dental | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 126 | $90K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 213 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 145 | $37K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 145 | $146K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 150 | $22K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 145 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.