| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVC | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $3K | $17K | 9.74% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 2.07% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $743 | $743 | 0.41% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVC | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $8K | 10.17% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.72% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $285 | $285 | 0.34% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVC | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $960 | $5K | 9.58% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.19% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH STREET, STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $351 | $351 | 0.64% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVC | 800 MAIN STREET DUBUQUE, IA 52001 | HUMANA INSURANCE COMPANY | $3K | $162 | $3K | 9.48% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | HUMANA INSURANCE COMPANY | $255 | — | $255 | 0.83% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | PO BOX 28 DUBUQUE, IA 52004 | HUMANA INSURANCE COMPANY | -$5 | — | -$5 | -0.02% |
| CORPORATE HEALTH SYSTEMS INC3 Filed as: CORPORATE HEALTH SYSTEMS | 15153 TECHNOLOGY DRIVE, STE B EDEN PRAIRIE, MN 55344 | HUMANA INSURANCE COMPANY | -$6 | — | -$6 | -0.02% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVC | 800 MAIN STREET DUBUQUE, IA 52004 | HARTFORD LIFE AND ACCIDENT | $477 | — | $477 | 15.01% |
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 | 323 | 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) | 325 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | HUMANA INSURANCE COMPANY | 202 | $31K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $262K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $179K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $234K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 440 | $265K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.