| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $76K | $2K | $79K | 15.47% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $934 | $11K | 5.48% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERV | 800 MAIN STREET DUBUQUE, IA 52001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $23K | — | $23K | 13.64% |
| ROCKLINE INDUSTRIES, INC.3 | 4343 S. TAYLOR DR. SHEBOYGAN, WI 53081 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 1.18% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $593 | $5K | 3.76% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERV | 800 MAIN STREET DUBUQUE, IA 52001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 13.65% |
| ROCKLINE INDUSTRIES, INC.3 | 4343 S. TAYLOR DR. SHEBOYGAN, WI 53081 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 1.60% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $243 | $7K | 15.53% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $43 | $4K | 9.76% |
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 | 2,310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 962 | $190K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,310 | $126K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 504 | $193K |
| Other(7 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,310 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,310 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.