| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PEDERSON DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSON, DOWIE, CLABBY & | MCCAUSLAND INS 3022 AIRPORT BLVD PO 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $4K | $625 | $5K | 4.94% |
| PEDERSON DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSON, DOWIE, CLABBY & | MCCAUSLAND INS 3022 AIRPORT BLVD PO 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $811 | — | $811 | 0.86% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 15.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.18% |
| PEDERSON DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 20.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $538 | $538 | 2.24% |
| PEDERSON DOWIE CLABBY & MCCAUSLAND3 Filed as: PEDERSON, DOWIE, CLABBY & | MCCAUSLAND INSURANCE, INC. 622 PROGRESS AVENUE WATERLOO, IA 50701 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.05% |
| PEDERSON DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $3K | 18.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $439 | $439 | 2.40% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 3022 AIRPORT BLVD WATERLOO, IA 50704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $855 | $3K | 22.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $244 | $244 | 2.15% |
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 | 154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 127 | $396K |
| Dental | DELTA DENTAL OF IOWA | 120 | $95K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 161 | $22K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $30K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 157 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $24K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 154 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.