| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52004 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $19K | — | $19K | 2.64% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $7K | — | $7K | 0.96% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 6.39% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DR APPLETON, WI 54915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $896 | $206 | $1K | 4.94% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $886 | $74 | $960 | 4.30% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | $16 | $168 | 0.75% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY ST FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $3 | $15 | 0.07% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST PO BOX 28 DUBUQUE, IA 52004 | CARE-PLUS DENTAL PLANS, INC. | $1K | — | $1K | 6.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC | 800 MAIN ST DUBUQUE, IA 52001 | UNION SECURITY INSURANCE COMPANY | $2K | $340 | $3K | 15.17% |
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 | 116 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 42 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 186 | — |
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.