| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PDCM INSURANCE Filed as: PDCM | 3022 AIRPORT BLVD PO BOX 2597 WATERLOO, IA 50704 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | — | — | $0 | 0.00% |
| PEDERSEN DOWIE CLABBY3 Filed as: PEDERSEN, DOWIE, CLABBY & | MCCAUSLAND INS 3022 AIRPORT BLVD PO BOX 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $3K | — | $3K | 4.69% |
| PEDERSEN DOWIE CLABBY3 Filed as: PEDERSEN, DOWIE, CLABBY & | MCCAUSLAND INS 3022 AIRPORT BLVD PO BOX 2597 WATERLOO, IA 50703 | DELTA DENTAL OF IOWA | $576 | $484 | $1K | 1.74% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 13.28% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 8.54% |
| PEDERSEN DOWIE CLABBY | 3022 AIRPORT BLVD PO BOX 2597 WATERLOO, IA 507039692 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $261 | — | $261 | 10.01% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $251 | $251 | 9.62% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 112 | $1.2M |
| Dental | DELTA DENTAL OF IOWA | 91 | $61K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 85 | $15K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 153 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.