| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | SERVICES, INC. P.O. BOX 28 DUBUQUE, IA 520040028 | HCC LIFE INSURANCE COMPANY | $0 | $28K | $28K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELLMARK EIN 42-1455449 TPA | Direct payment from the plan; Claims processing Service code 12 | — | $584K |
| BUTLER HEALTHCORP INC EIN 42-1403200 DIVISION OF EMPLOYER | Other services Service code 49 | — | $265K |
| TELADOC HEALTH EIN 04-3705497 TELEMEDICINE PROVIDER | Claims processing; Direct payment from the plan Service code 12 | — | $112K |
| SELF INSURED SERVICES COMPANY EIN 42-1144827 DIVISION OF EMPLOYER | Direct payment from the plan; Claims processing Service code 12 | — | $63K |
| OPTUMRX EIN 33-0441200 PBM | Direct payment from the plan; Claims processing Service code 12 | — | $25K |
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 | 1,971 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,984 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 922 | $704K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 922 | — |
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.