| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $37K | $39K | 3.49% |
| ARMS INSURANCE GROUP LLC3 | 3000 LENTO BLVD BETHEL PARK, PA 15102 | UNITEDHEALTHCARE INSURANCE COMPANY | — | -$10 | -$10 | -0.00% |
| JON NISTAD3 Filed as: JON N NISTAD | 108 CENTRE BLVD STE D MARLTON, NJ 08053 | UNITEDHEALTHCARE INSURANCE COMPANY | -$14 | -$112 | -$126 | -0.01% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $17K | $299 | $17K | 10.41% |
| NISTAD, JON N3 Filed as: NISTAD JON N | 108 D CENTRE BLVD MARLTON, NJ 08053 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $692 | — | $692 | 0.42% |
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 | 192 | 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) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 374 | $1.1M |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 105 | $166K |
| Life insurance | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 105 | $166K |
| Short-term disability | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 105 | $166K |
| Long-term disability | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 105 | $166K |
| Other | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 105 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.