| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 | 150 E 4TH PL STE 306 SIOUX FALLS, SD 57104 | DELTA DENTAL OF SOUTH DAKOTA | $1K | — | $1K | 2.21% |
| HOLMES MURPHY & ASSOCIATES3 | PO BOX9207 DES MOINES, IA 50306 | SUNLIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 9.34% |
| HOLMES MURPHY & ASSOCIATES3 | PO BOX 441 DES MOINES, IA 50302 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 23.58% |
| HOLMES MURPHY & ASSOCIATES | PO BOX 9207 DES MOINES, IA 50306 | SUNLIFE ASSURANCE COMPANY OF CANADA | $147 | — | $147 | 10.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Other fees; Direct payment from the plan; Float revenue Service code 12 | — | $165K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 11 SCOTT ST WAUSAU, WI 544034875 | $67K |
| HOLMES MURPHY & ASSOCIATES EIN 42-0985055 BROKER | Other commissions; Claims processing Service code 12 | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | $31K |
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 | 157 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 152 | $66K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 157 | $9K |
| Life insurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 102 | $15K |
| Short-term disability | SUNLIFE ASSURANCE COMPANY OF CANADA | 102 | $15K |
| Stop-loss / reinsurancereinsurance | EAST COAST UNDERWRITERS | 77 | $285K |
| Other | SUNLIFE ASSURANCE COMPANY OF CANADA | 102 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.