| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SISCO3 | 300 SECURITY BUILDING PO BOX 28 DUBUQUE, IA 52004 | GERBER LIFE INSURANCE COMPANY | $50K | $40K | $91K | 20.77% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: TWO RIVERS INSURANCE COMPANY | 4500 WESTOWN PKWY STE 150 WEST DES MOINES, IA 50266 | METROPOLITAN LIFE INSURANCE COMPANY | $309 | $0 | $309 | 0.31% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL IOWA LLC | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | METROPOLITAN LIFE INSURANCE COMPANY | $136 | $60 | $196 | 0.20% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $82 | $82 | 0.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL IOWA LLC | 15162 COLLECTIONS CENTER DR CHICAGO, IL 60693 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 13.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL IOWA LLC | 15162 COLLECTIONS CENTER CHICAGO, IL 60693 | MTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL IOWA LLC | 15162 COLLECTIONS CENTER DR CHICAGO, IL 60693 | MTUAL OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHCORP EIN 42-1403200 NURSE CASE MANAGER | Other fees Service code 99 | 300 SECURITY BUILDING PO BOX 28 DUBUQUE, IA 52004 | $0 |
| QUAD CITY COMMUNITY HEALTHCARE EIN 20-8340437 PPO | Other fees Service code 99 | PO BOX 389 DUBUQUE, IA 52004 | $0 |
| SISCO EIN 42-1144827 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | 300 SECURITY BUILDING PO BOX 28 DUBUQUE, IA 52004 | $0 |
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 | 251 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GERBER LIFE INSURANCE COMPANY | 251 | $436K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 348 | $100K |
| Life insurance(2 contracts) | MTUAL OF OMAHA LIFE INSURANCE COMPANY | 225 | $32K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 225 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 348 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.