| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MIDWESTERN INS ASSOC AGY INC3 Filed as: MIDWESTERN INS ASSOCS INC | PO BOX 410 MINIER, IL 61759 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 7.67% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INSURANCE SERVICES LLC | 4321 EAST 60TH STREET DAVENPORT, IA 52807 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $643 | $2K | 14.02% |
| 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 | — | $692 | $692 | 5.02% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SOUTHEAST SUITE 1950 ATLANTA, GA 30339 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $454 | $2K | 19.01% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 142 | $50K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 142 | $50K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 52 | $11K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 75 | $338K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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."
No prospect flags tripped on this filing.