| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INC | 11516 MIRACLE HILLS DRIVE, STE 102 OMAHA, NE 68154 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $72K | — | $72K | 2.05% |
| MICAH VIS3 | 1508 12TH AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27K | $11K | $38K | 23.37% |
| GERRIT VIS3 | 3147 ELMWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $5K | $9K | 5.57% |
| JODI LYNN VANBEEK3 | 1502012TH AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $816 | $4K | 2.61% |
| GRANT KLEIN3 | 2894 300TH STREET HULL, IA 51239 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.87% |
| TMB ENTERPRISES INC3 | 1307 EAST 31ST KEARNEY, NE 68847 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $459 | $0 | $459 | 0.28% |
| JOEL FENNEMA3 | 1570 SUNRISE CIRCLE SIOUX CENTER, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $44 | $117 | 0.07% |
| AMBER LYNN ZOMER3 | 3121 DOVE AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $3 | $65 | 0.04% |
| BENTON TAYLOR3 | PO BOX 543 SPENCER, IA 51301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| MICAH VIS3 | 1508 12TH AVE ROCK VALLEY, IA 51247 | AMERITAS | $5K | $0 | $5K | 10.00% |
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 | 461 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 356 | $3.5M |
| Dental | AMERITAS | 250 | $52K |
| Vision | AMERITAS | 250 | $52K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 461 | $163K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 461 | $163K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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.
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.