| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | PO BOX 28 DUBUQUE, IA 52004 | ANTHEM INSURANCE COMPANIES, INC. | $31K | $462 | $32K | 2.64% |
| BENJAMIN G STAHL3 | 2225 CENTRALAVE. COLUMBUS, IN 47201 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 6.49% |
| VOLUNTARY BENEFIT PLANS LLC3 | 5101 DUNEWOOD WAY AVON, IN 46123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.43% |
| ROGLE INC3 | 7460 LANTERN ROAD INDIANAPOLIS, IN 46256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $340 | $192 | $532 | 1.12% |
| KAMI L STANLEY3 | 3303 S 79TH ST LINCOLN, NE 68506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $303 | $227 | $530 | 1.12% |
| ERC OF NY, INC.3 Filed as: ERC OF NY | 400 POST AVE STE 210 WESTBURY, NY 11590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $345 | — | $345 | 0.73% |
| TOMPKINS INSURANCE AGENCIES3 Filed as: TOMPKINS INSURANCE AGENCIES INC | C/O TOMPKINS INSURANCE DOWNINGTOWN, PA 19335 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.08% |
| BROKERAGE CONCEPTS INC3 | PO BOX 742 BLUE BELL, PA 19422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.07% |
| GARY A INERSON3 | 516 N MARBLE WAY FORTVILLE, IN 46040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 0.05% |
| GARY D DAVIS3 | 1 ARCTURUS DR SEWELL, NJ 08080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| ELITE ADMINISTRATION3 | 313 HARKINS BLUFF DR GREER, SC 29651 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| KERRY THERESA CONNOR3 | 119 GALLAGHER RD WAYNE, PA 19087 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | 800 MAIN STREET DUBUQUE, IA 52001 | ANTHEM LIFE INSURANCE COMPANY | $5K | $215 | $5K | 11.81% |
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 | 225 | 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) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM INSURANCE COMPANIES, INC. | 300 | $1.2M |
| Dental | ANTHEM INSURANCE COMPANIES, INC. | 300 | $1.2M |
| Vision | ANTHEM INSURANCE COMPANIES, INC. | 300 | $1.2M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 226 | $43K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 43 | $47K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 226 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.