| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| V AND S MARKETING3 | 3147 ELMWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23K | $18K | $41K | 41.68% |
| MAVIS BENEFITS LIC3 | 3188 DOGWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $4K | $12K | 12.51% |
| JODI LYNN VANBEEK3 | 1502 12TH AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 6.09% |
| REYNALDO CASTILLO3 | 205 SEEFIELD ST ALVORD, IA 51230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $830 | $1K | $2K | 2.04% |
| DAWSON VIS3 | 1908 15TH ST ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $442 | $336 | $778 | 0.80% |
| APRIL DE KAM3 | 1824 SOUTHERN HILLS DR ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | $192 | $313 | 0.32% |
| NANCY CLAUSSEN3 | 2309 S MACEY AVE SIOUX FALLS, SD 57106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.01% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: NICOLLE MARIE BROWN | 7424 S BALLYMORE CIR SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| V AND S MARKETING3 | 3147 ELMWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 18.68% |
| MAVIS BENEFITS LLC3 | 3188 DOGWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $923 | $484 | $1K | 3.53% |
| JODI LYNN VANBEEK3 | 1502 12TH AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $679 | $276 | $955 | 2.39% |
| REYNALDO CASTILLO3 | 205 SEEFIELD ST ALVORD, IA 51230 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | $183 | $313 | 0.78% |
| APRIL DE KAM3 | 1824 SOUTHERN HILLS DR ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $103 | $168 | 0.42% |
| NANCY CLAUSSEN3 | 2309 S MACEY AVE SIOUX FALLS, SD 57106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.19% |
| DAWSON VIS3 | 1908 15TH ST ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $19 | $46 | 0.12% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: NICOLLE MARIE BROWN | 7424 S BALLYMORE CIR SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| KHI SOLUTIONS LLC3 Filed as: KHI SOLUTIONS, LLC | 130 NORTH 25TH STREET FORT DODGE, IA 50501 | DELTA DENTAL OF IOWA | $1K | — | $1K | 6.90% |
| CENTER BENEFITS LLC3 | PO BOX 11 SIOUX CENTER, IA 51250 | VISION SERVICE PLAN | $373 | — | $373 | 8.97% |
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 | 106 | 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) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 26 | $790K |
| Dental | DELTA DENTAL OF IOWA | 20 | $19K |
| Vision | VISION SERVICE PLAN | 21 | $4K |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 110 | $98K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 48 | $40K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 110 | $98K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 110 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.