| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLMARK INC | PO BOX 10481 DES MOINES, IA 50306 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE SEGAL COMPANY EIN 13-1835864 | Actuarial; Consulting (general) Service code 11 | 3800 AMERICAN BLVD WEST BLOOMINGTON, MN 55431 | $90K |
| MELISSA BAILEY EIN 42-0842882 | Plan Administrator Service code 14 | 1501 E AURORA AVE STE B DES MOINES, IA 503133912 | $39K |
| DEBOER & ASSOCIATES, PC EIN 47-0836395 | Accounting (including auditing) Service code 10 | 17330 WRIGHT ST STE100 OMAHA, NE 68130 | $34K |
| COMMUNITY STATE BANK EIN 42-0839178 | Trustee (bank, trust company, or similar financial institution); Custodial (securities); Investment management Service code 19 | PO BOX 308 JOHNSTON, IA 50131 | $17K |
| BLAKE & UHLIG EIN 48-0918231 | Legal Service code 29 | 753 STATE AVENUE KANSAS CITY, KS 66101 | $11K |
| FIDUCIENT ADVISORS LLC EIN 36-4001764 | Investment advisory (plan) Service code 27 | 500 W MADISON ST, STE 170 CHICAGO, IL 606614593 | $8K |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 107 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 94 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 431 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 251 | $2.9M |
| Dental | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 251 | $179K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 442 | $63K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 442 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 442 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.