| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $28K | — | $28K | 3.53% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.40% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DR APPLETON, WI 54915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $971 | $147 | $1K | 4.52% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $45 | $1K | 4.39% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $3 | $41 | 0.17% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY ST FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST PO BOX 28 DUBUQUE, IA 52004 | CARE-PLUS DENTAL PLANS, INC. | $1K | — | $1K | 6.13% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC | PO BOX 28 DUBUQUE, IA 52004 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 14.16% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 175 | $789K |
| Dental | CARE-PLUS DENTAL PLANS, INC. | 81 | $24K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 113 | $20K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 113 | $20K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 113 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.