| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | 800 MAIN ST DUBUQUE, IA 52001 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | $53K | $999 | $54K | 2.41% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS | PO BOX 28 DUBUQUE, IA 52004 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $10K | $25K | 16.67% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | CARE-PLUS DENTAL PLANS, INC. | $2K | — | $2K | 6.00% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE INSURANCE GROUP | PO BOX 389 MENASHA, WI 54952 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 13.14% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $960 | — | $960 | 2.41% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $3K | — | $3K | 9.99% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 18.90% |
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 | 325 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | 219 | $2.3M |
| Dental | CARE-PLUS DENTAL PLANS, INC. | 117 | $41K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 364 | $31K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $152K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $152K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $152K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 325 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 364 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.