| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC. | 800 MAIN STREET DUBUQUE, IA 52001 | BLUECROSS BLUESHIELD OF ILLINOIS | $52K | $2K | $54K | 2.78% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | BLUECROSS BLUESHIELD OF ILLINOIS | $24K | $6 | $24K | 1.22% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $3K | $17K | 16.50% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $722 | $8K | 7.75% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | STARMOUNT LIFE INSURANCE COMPANY | $6K | $2K | $7K | 8.96% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $529 | $3K | 3.89% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM INSURANCE COMPANY | $4K | $786 | $4K | 14.09% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM INSURANCE COMPANY | $1K | $144 | $1K | 3.88% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC. | PO BOX 28 DUBUQUE, IA 52004 | VISION SERVICE PLAN | $905 | $0 | $905 | 6.81% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 745977 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $422 | $0 | $422 | 3.18% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 173 | $2.0M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 93 | $82K |
| Vision | VISION SERVICE PLAN | 85 | $13K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 103 | $105K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 103 | $105K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 103 | $105K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 173 | $2.0M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 103 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.