| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PHILLIP DOWTY3 | 15616 COUNTRY ROAD 44 GOSHEN, IN 46526 | EMC NATIONAL LIFE | $10K | — | $10K | 7.54% |
| KRISTA L SIGMAN3 | 800 MAIN STREET DUBUQUE, IA 52001 | EMC NATIONAL LIFE | $5K | — | $5K | 3.41% |
| SUPPLEMENTAL INS SVCS INC3 Filed as: SUPPLEMENTAL INSURANCE SERVICES | 115 E PLATT STREET MAQUOKETA, IA 520602337 | EMC NATIONAL LIFE | $2K | — | $2K | 1.28% |
| ROGER HARDIN3 Filed as: ROGER HARDIN INSURANCE INC | 578 237TH AVE DELMAR, IA 52037 | EMC NATIONAL LIFE | $11 | — | $11 | 0.01% |
| MELISSA HANKNER3 | 1001 BATTLES DR MAQUOKETA, IA 52060 | EMC NATIONAL LIFE | $5 | — | $5 | 0.00% |
| DANE PAPE3 | 115 E PLATT ST MAQUOKETA, IA 52060 | EMC NATIONAL LIFE | $5 | — | $5 | 0.00% |
| INSURANCE BENEFIT ADVISORS3 Filed as: INSURANCE BENEFIT SERVICES | 429 S BLANCHE ST MOUNDS, IL 62964 | EMC NATIONAL LIFE | $1 | — | $1 | 0.00% |
| MICHAEL HILEMAN3 | 429 S BLANCHE ST MOUNDS, IL 62964 | EMC NATIONAL LIFE | $1 | — | $1 | 0.00% |
| RHONDA S PAPE3 Filed as: RHONDA PAPE | 115 E PLATT ST MAQUOKETA, IA 52060 | EMC NATIONAL LIFE | $1 | — | $1 | 0.00% |
| SAMUEL PAPE3 | 1613 MEADOW RIDGE CT ANAMOSA, IA 52205 | EMC NATIONAL LIFE | $0 | — | $0 | 0.00% |
| COLE PAPE3 | 115 E PLATT ST MAQUOKETA, IA 52060 | EMC NATIONAL LIFE | $0 | — | $0 | 0.00% |
| BRISSENDEN CONSULTANT SERVICES3 | 2105 REDBUD ST EFFINGHAM, IL 62401 | EMC NATIONAL LIFE | $0 | — | $0 | 0.00% |
| DOWTY, PHILLIP3 | 15616 COUNTY ROAD 44 GOSHEN, IN 46526 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.55% |
| COTTINGHAM & BUTLER3 | INSURANCE SERVICE 800 MAIN STREET DUBUQUE, IA 52001 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.34% |
| SUPPLEMENTAL INS SVCS INC3 Filed as: SUPPLEMENTAL INSURANCE SERVICES, IN | 115 E PLATT STREET MAQUOKETA, IA 520602337 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $664 | — | $664 | 1.11% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | EMC NATIONAL LIFE | 553 | $138K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 105 | $60K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 105 | $60K |
| Other(3 contracts, 3 carriers) | EMC NATIONAL LIFE | 582 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 582 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.