| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS Filed as: ASSUREDPARTNERS GREAT PLAINS LLC | 2501 W BELTLINE HWY STE 201 MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $23K | $0 | $23K | 13.95% |
| GROUP BENEFIT PARTNERS LLC3 | 914 AVENUE G FORT MADISON, IA 52627 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.47% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS DBA GROUP BENEFIT P | 914 AVENUE G FORT MADISON, IA 52627 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 13.46% |
| RYAN BERVEN3 | 4200 UNIVERSITY AVE SUITE 200 WEST DES MOINES, IA 50266 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 5.04% |
| CALVIN J KOHLENBERG3 Filed as: CALVIN KOHLENBERG | PO BOX 1513 DUBUQUE, IA 52004 | TRANSAMERICA LIFE INSURANCE COMPANY | $187 | — | $187 | 0.70% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS DBA GROUP BENEFIT P | 914 AVENUE G FORT MADISON, IA 52627 | VERATRUS BENEFIT SOLUTIONS | $2K | — | $2K | 9.77% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS DBA GROUP BENEFIT P | 914 AVENUE G FORT MADISON, IA 52627 | DELTA DENTAL OF IOWA | $7K | — | $7K | — |
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 | 559 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 195 | $1.6M |
| Dental | DELTA DENTAL OF IOWA | 224 | $0 |
| Vision | VERATRUS BENEFIT SOLUTIONS | 218 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 559 | $162K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 559 | $162K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 559 | $162K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 559 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 559 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.