| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KHI SOLUTIONS LLC3 | 130 NORTH 25TH STREET FORT DODGE, IA 50501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 15.01% |
| GRETCHEN J ZOMERMAAND3 Filed as: GRETCHEN ZOMERMAAND, CHFC | 1230 S MAIN AVE SIOUX CENTER, IA 51250 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.00% |
| ZEUTENHORST FINANCIAL3 | 1230 S MAIN AVE SIOUX CENTER, IA 51250 | DELTA DENTAL OF IOWA | $411 | — | $411 | 3.79% |
| KHI SOLUTIONS LLC3 | 130 NORTH 25TH STREET FORT DODGE, IA 50501 | DELTA DENTAL OF IOWA | $199 | $104 | $303 | 2.79% |
| CENTER BENEFITS LLC3 | PO BOX 11 SIOUX CENTER, IA 51250 | VISION SERVICE PLAN | $359 | — | $359 | 9.82% |
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 BLUE SHIELD OF IOWA | 23 | $796K |
| Dental | DELTA DENTAL OF IOWA | 13 | $11K |
| Vision | VISION SERVICE PLAN | 18 | $4K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 106 | $81K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 106 | $81K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 106 | $81K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 106 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.