| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF IOWA | $4K | $283 | $4K | 5.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 4.42% |
| SELECT NETWORKS3 | 6165 NW 86TH STREET, SUITE 108 ROGERS, AR 72756 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 901 NORTH 47TH STREET, SUITE 1300 CINCINNATI, OH 50131 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.77% |
| SETH VIS3 | 3256 JEFFERSON AVENUE BOYDEN, IA 51234 | AFLAC | $172 | $0 | $172 | 3.68% |
| MJ INSURANCE3 Filed as: CAROL L. PLATT AND VARIOUS AGENTS | 606 7TH STREET SPIRIT LAKE, IA 51360 | AFLAC | $119 | $0 | $119 | 2.55% |
| GERRIT J VIS3 Filed as: GERRIT J. VIS | 1435 MAIN STREET ROCK VALLEY, IA 51247 | AFLAC | $60 | $0 | $60 | 1.28% |
| STEVEN L. VONK3 | 1602 10TH STREET ROCK VALLEY, IA 51247 | AFLAC | $56 | $0 | $56 | 1.20% |
| DAVID R HOPKINS3 Filed as: DAVID R. HOPKINS | PO BOX 555 SPIRIT LAKE, IA 51360 | AFLAC | $54 | $0 | $54 | 1.16% |
| VON ENGELENHOVEN AGENCY, INC.3 | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | AFLAC | $37 | $0 | $37 | 0.79% |
| JANE W BARNHILL3 Filed as: JANE M. POTTEBAUM | 19258 HAWTHORNE AVENUE CARROLL, IA 51401 | AFLAC | $24 | $0 | $24 | 0.51% |
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 | 244 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF IOWA | 74 | $78K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 194 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 244 | $51K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 244 | $51K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 244 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.