| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SISCO5 | PO BOX 389 DUBUQUE, IA 520040389 | ANTHEM LIFE INSURANCE | — | $103K | $103K | 12.84% |
| QCCH0 | 246 W 3RD ST, STE 100 DAVENPORT, IA 52801 | ANTHEM LIFE INSURANCE | — | $21K | $21K | 2.59% |
| HEALTHCORP0 | PO BOX 1475 DUBUQUE, IA 520041475 | ANTHEM LIFE INSURANCE | — | $19K | $19K | 2.40% |
| HEALTHLINK0 | PO BOX 6501 CAROL STREAM, IL 601976501 | ANTHEM LIFE INSURANCE | — | $13K | $13K | 1.64% |
| PCHS0 | 3345 MICHELSON DR IRVINE, CA 92612 | ANTHEM LIFE INSURANCE | — | $3K | $3K | 0.37% |
| HFN0 | 1315 W 22ND ST, STE 300 OAK BROOK, IL 60522 | ANTHEM LIFE INSURANCE | — | $892 | $892 | 0.11% |
| FIRST HEALTH WRAP0 | 23276 NETWORK PL CHICAGO, IL 606731232 | ANTHEM LIFE INSURANCE | — | $578 | $578 | 0.07% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM &BUTLER INS SERVICES INC | PO BOX 28 DUBUQUE, IA 520040028 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $7K | $12K | 6.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SISCO VENDOR | Contract Administrator Service code 13 | PO BOX 389 DUBUQUE, IA 52004 | $103K |
| QCCH VENDOR | Contract Administrator Service code 13 | 246 W 3RD ST, STE 100 DAVENPORT, IA 52801 | $21K |
| HEALTHCORP VENDOR | Contract Administrator Service code 13 | PO BOX 1475 DUBUQUE, IA 52004 | $19K |
| HEALTHLINK VENDOR | Contract Administrator Service code 13 | PO BOX 6501 CAROL STREAM, IL 60197 | $13K |
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 | 348 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM LIFE INSURANCE | 348 | $803K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 348 | $167K |
| 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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.