| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $85K | $18K | $103K | 10.35% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC. | PO BOX 28 DUBUQUE, IA 52004 | UNITED HEALTH CARE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| PROES INC.3 | 5488 E SR 46 BLOOMINGTON, IN 47401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.71% |
| RONALD F REMAK INSURANCE INC3 | 306 STATE RD 446 BLOOMINGTON, IN 47401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.64% |
| MCKELVEY, PHILIP, NEILL3 Filed as: MCKELVEY, PHILIP, N | 3931 S DIXIE DR DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.59% |
| REMAK, RONALD, F3 | 306 S STATE RD 446 BLOOMINGTON, IN 47401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.15% |
| BRAFFORD, MICKY, L3 | 5488 EAST ST RD 46 BLOOMINGTON, IN 47401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.15% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN ST DUBUQUE, IA 52001 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.08% |
| CLARK, MICHAEL3 | 103 W HOWARD ST GALVESTON, IN 46932 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
| BOETTJER, DAVE,3 | 2521 S WEBSTER ST KOKOMO, IN 46902 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.02% |
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 | 1,039 | 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) | 1,039 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 998 | $997K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 998 | $997K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 998 | $997K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 998 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 998 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.