| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS INC | 800 MAIN STREET DUBUQUE, IA 52001 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $52K | — | $52K | 1.58% |
| ALLIANT INSURANCE SERVICES, INC.3 | 32 OLD SLIP FLOOR 29 NEWYORK, NY 10005 | BLUECROSS BLUESHIELD OF OKLAHOMA | $9K | — | $9K | 2.47% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS INC | 800 MAIN STREET DUBUQUE, IA 52001 | BLUECROSS BLUESHIELD OF OKLAHOMA | $9K | — | $9K | 2.44% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE SUITE 1900 TULSA, OK 74136 | BLUECROSS BLUESHIELD OF OKLAHOMA | $5K | — | $5K | 1.53% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS | INC 800 MAIN ST DUBUQUE, IA 52001 | MUTUAL OF OMAHA INSURANCE COMPANY | $9K | $796 | $10K | 5.81% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS | INC 800 MAIN ST DUBUQUE, IA 52001 | COMPANION LIFE INSURANCE COMPANY | $6K | $335 | $7K | 7.82% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INSURANCE SER | 800 MAIN STREET DUBUQUE, IA 52001 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $52 | $1K | 5.51% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $643 | — | $643 | 2.92% |
| SENTINEL INSURANCE AGENCY, INC.3 Filed as: SENTINEL INSURANCE AGENCY INC | 100 QUANNAPOWITT PARKWAY SUITE 300 WAKEFIELD, MA 01880 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $606 | — | $606 | 2.75% |
| BULFINCH GROUP INSURANCE AGY L3 | 160 GOULD ST #310 NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.05% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MID-AMERICA | 425 WEST CAPITOL AVENUE SUITE 3550 LITTLE ROCK, AR 72202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 19.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.11% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INSURANCE | 800 MAIN STREET DUBUQUE, IA 52001 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 6.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SERVICES | PO BOX 28 DUBUQUE, IA 52004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 7.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 32 OLD SLIP FLOOR 29 NEW YORK, NY 10005 | SUN LIFE ASSURANCE COMPANY OF CANADA | $691 | — | $691 | 4.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 6100 SOUTH YALE AVENUE SUITE 1900 TULSA, OK 74136 | SUN LIFE ASSURANCE COMPANY OF CANADA | $518 | — | $518 | 3.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $2K |
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 | 462 | 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) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 462 | $3.6M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 462 | $3.3M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 462 | $3.3M |
| Life insurance(4 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 364 | $295K |
| Short-term disability(3 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 363 | $209K |
| Long-term disability(3 contracts, 3 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 363 | $203K |
| Other(3 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 363 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 462 | — |
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.