| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIDWESTERN INS ASSOC AGY INC3 | PO BOX 410 MINIER, IL 61759 | HUMANA INSURANCE COMPANY | $4K | $3K | $7K | 12.06% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 17.44% |
| STEPHEN R LEESMAN3 | 201 SOUTH MAIN AVENUE PO BOX 410 MINIER, IL 61759 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 14.99% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INSURANCE SERVICES LLC | 4321 EAST 60TH STREET DAVENPORT, IA 52807 | DEARBORN LIFE INSURANCE COMPANY | — | $745 | $745 | 5.02% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $898 | $3K | 22.49% |
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 | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA INSURANCE COMPANY | 85 | $59K |
| Vision | HUMANA INSURANCE COMPANY | 85 | $59K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 53 | $12K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 78 | $302K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.