| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZACH CORPORATION3 Filed as: ZACH CORPORATION DBA GROUP BEN | 622 PROGRESS AVENUE PO BOX 2597 WATERLOO, IA 50701 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $42K | — | $42K | 2.80% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSEN,DOWIE,CLABBY & MCCAUSLAND | 3022 AIRPORT BOULEVARD PO BOX 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $9K | $1K | $10K | 11.37% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BOULEVARD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 14.32% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $809 | $809 | 1.92% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BOULEVARD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 14.47% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $575 | $575 | 1.99% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BOULEVARD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $916 | $3K | 14.33% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $407 | $407 | 1.92% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BOULEVARD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $667 | $2K | 14.33% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $296 | $296 | 1.92% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BOULEVARD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $581 | $2K | 14.44% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS LLC | 501 OFFICE CENTER DRIVE SUITE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $258 | $258 | 1.97% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF IOWA | 148 | $86K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 148 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $44K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $42K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $21K |
| Stop-loss / reinsurancereinsurance | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 139 | $1.5M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 171 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.