| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 Filed as: GROUP SERVICES | 3066 VICTORIA STREET BETTENDORF, IA 52722 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 8.47% |
| TINA M LASSUY3 Filed as: TINA M. LASSUY | 3021 45TH STREET MOLINE, IL 61265 | AFLAC | $4K | $102 | $4K | 8.57% |
| STEVEN L. SWANSON3 | 1523 47TH AVENUE, SUITE 3 MOLINE, IL 61265 | AFLAC | $3K | $113 | $3K | 6.30% |
| CHRISTOPHER J BAYER3 Filed as: CHRISTOPHER J. BAYER | 1416 NORTH BROAD STREET GALESBURG, IL 61401 | AFLAC | $757 | $38 | $795 | 1.87% |
| TERRY J SILVERS3 Filed as: TERRY J. SILVERS AND OTHER AGENTS | 100 GREENLEAF DRIVE FLAT ROCK, NC 28731 | AFLAC | $555 | $38 | $593 | 1.39% |
| JOHN D LASSUY3 Filed as: JOHN D. LASSUY | 4544 3RD STREET MOLINE, IL 61265 | AFLAC | $237 | $0 | $237 | 0.56% |
| DEBRA S. HERBERS AND OTHER AGENTS3 Filed as: DEBRA S. HERBERS | 410 PRAIRIE MEADOW DRIVE BLUE GRASS, IA 52726 | AFLAC | $167 | $14 | $181 | 0.43% |
| GREGORY J SHARP3 Filed as: GREGORY J. SHARP | 702 EAST 5TH STREET COAL VALLEY, IL 61240 | AFLAC | $125 | $0 | $125 | 0.29% |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | 121 | $539K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $156K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $113K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $156K |
| Short-term disability | AFLAC | 108 | $43K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $113K |
| Prescription drug | UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. | 121 | $539K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 196 | $156K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.