| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARIE L FELLOWS3 | 1968 MEADOW RIDGE LANE IOWA CITY, IA 52245 | AFLAC | $4K | $112 | $4K | 3.13% |
| VARIOUS BROKERS 100 COMMISSIONS3 | DETAIL AVAILABLE UPON REQUEST NORTH LIBERTY, IA 52317 | AFLAC | $4K | $48 | $4K | 3.03% |
| BETTY G BRUNSVOLD3 Filed as: BETTY BRUNSVOLD | 802 S MILL LAKE MILLS, IA 50450 | AFLAC | $3K | $112 | $3K | 2.22% |
| JUDITH CARRILLO3 | 2646 HARRISON STREET OMAHA, NE 68147 | AFLAC | $2K | $85 | $2K | 1.63% |
| JOHN W BARNARD3 Filed as: JOHN BARNARD | 1178 WADE STREET HIGHLAND PARK, IL 60035 | AFLAC | $1K | $21 | $1K | 0.91% |
| SHARON R LUCARELLI3 Filed as: SHARON LUCARELLI | 12725 BENNINGTON COMMON LN ST LOUIS, MO 63146 | AFLAC | $831 | $42 | $873 | 0.71% |
| HEIDI BYKONEN3 | 2209 24TH ST W BILLINGS, MT 59102 | AFLAC | $804 | $57 | $861 | 0.70% |
| JOHN W BARNARD3 | 490 E ROOSEVELT RD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $779 | — | $779 | 0.63% |
| JEANNE T SCHWAB3 | 2655 MIDDLE RD DAVENPORT, IA 52803 | AFLAC | $716 | $17 | $733 | 0.59% |
| MELISSA J SELZLER3 | 206 5TH AVE W VELVA, ND 58790 | AFLAC | $697 | — | $697 | 0.56% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS INSURANCE INC | 465 NORTHLAND AVE NE SUITE 201 CEDAR RAPIDS, IA 52402 | AFLAC | $584 | $32 | $616 | 0.50% |
| STARR STRICKLAND3 | 1217 OLLIE WAY ROCKY MOUNT, NC 27804 | AFLAC | $586 | — | $586 | 0.47% |
| RONALD E KIRKLAND3 Filed as: RONALD D BEDDINGFIELD | 132 N ENGLEWOOD DR ROCKY MOUNT, NC 27804 | AFLAC | $580 | — | $580 | 0.47% |
| TYONIA N EGGERS3 | 607 ROSEWOOD AVE PAPILLION, NE 68133 | AFLAC | $479 | $30 | $509 | 0.41% |
| THE SHARON MILLER AGENCY LLC3 Filed as: SHARON K MILLER | PO BOX 553 LATIMER, IA 50452 | AFLAC | $500 | $3 | $503 | 0.41% |
| MARY ANN KELLER3 | 1930 28TH ST SW MINOT, ND 58701 | AFLAC | $467 | — | $467 | 0.38% |
| GERALD A GREENEN3 | 490 E ROOSEVELT RD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $407 | — | $407 | 0.33% |
| THE TODD GROUP3 | 602 MAIN ST STE 200 CEDAR FALLS, IA 50613 | AFLAC | $380 | $25 | $405 | 0.33% |
| LOREN MEYER3 | 2604 WEST EUCLID AVENUE INDIANOLA, IA 50125 | AFLAC | $397 | — | $397 | 0.32% |
| JONI S WOBORNY BUNKER3 | 1837 VIRGINIA DR MANHATTAN, KS 66502 | AFLAC | $327 | — | $327 | 0.26% |
| GREGORY D JOURGENSEN3 | 6524 RIVERBEND RD CHEYENNE, WY 82001 | AFLAC | $326 | — | $326 | 0.26% |
| MELISSA K SWAN3 | 204 S 35TH ST STE 100 COUNCIL BLUFFS, IA 51501 | AFLAC | $267 | $30 | $297 | 0.24% |
| MONICA WHITE3 | 28876 DELTA AVE TREYNOR, IA 51575 | AFLAC | $273 | — | $273 | 0.22% |
| CORY D NELSON3 | 215 HIGHWAY 965 NE STE 1 NORTH LIBERTY, IA 52317 | AFLAC | $255 | $2 | $257 | 0.21% |
| CHAD L NELSON3 | 490 E ROOSEVELT RD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $252 | — | $252 | 0.20% |
| DONALD L BYCROFT3 | 3500 KEYMEER DR APT 1 DUBUQUE, IA 52002 | AFLAC | $232 | $10 | $242 | 0.20% |
| MATTHEW D BUTLER3 Filed as: MATTHEW BUTLER | 123 CENTER PARK DR STE 102 KNOXVILLE, TN 37922 | AFLAC | $235 | — | $235 | 0.19% |
| DONNA R WATSON3 | 876 TANGLEFOOT LN BETTENDORF, IA 52722 | AFLAC | $204 | $31 | $235 | 0.19% |
| BRANDON RICHARD LONG3 | 1500 WINDERMERE WAY BROOKINGS, SD 57006 | AFLAC | $232 | — | $232 | 0.19% |
| REBEKAH N CHRIST3 Filed as: REBEKAH CHRIST | 1123 LAKE AVENUE STORM LAKE, IA 50588 | AFLAC | $218 | — | $218 | 0.18% |
| MARK FRIEHE3 | 4611 S 96TH ST STE 101 OMAHA, NE 68127 | AFLAC | $217 | — | $217 | 0.18% |
| PHYLLIS D KIMBALL3 | 1103 ORCHARD DR CRESTON, IA 50801 | AFLAC | $211 | — | $211 | 0.17% |
| ERIC SHATZ3 Filed as: ERIC M SHATZ | 10004 HARDY DRIVE OVERLAND PARK, KS 66212 | AFLAC | $191 | $16 | $207 | 0.17% |
| BETH ZADOW3 | 2400 S SHORE DR LOT 22 CLEAR LAKE, IA 50428 | AFLAC | $180 | $25 | $205 | 0.17% |
| NANCY KINTZLE3 | 26201 212TH AVE DELHI, IA 52223 | AFLAC | $185 | — | $185 | 0.15% |
| MARY E MINTON3 Filed as: MARY MINTON | 1344 SEVILLE WICHITA, KS 67209 | AFLAC | $169 | — | $169 | 0.14% |
| SHARON COX3 | 23524 W 73RD TER SHAWNEE, KS 66227 | AFLAC | $102 | $59 | $161 | 0.13% |
| ANDREW G THEIS3 | 2048 OVERLAND AVE STE 202 BILLINGS, MT 59102 | AFLAC | $149 | $11 | $160 | 0.13% |
| DUVEEN STRICKLAND3 | 1609 W ARLINGTON BLVD STE 105 GREENVILLE, NC 27834 | AFLAC | $157 | — | $157 | 0.13% |
| J THEIS & ASSOCIATES INC3 | 2048 OVERLAND AVE STE 202 BILLINGS, MT 59102 | AFLAC | $143 | $11 | $154 | 0.12% |
| STEVEN G JOHNSON3 | 35989 HIGHWAY 69 STE C FOREST CITY, IA 50436 | AFLAC | $132 | $20 | $152 | 0.12% |
| LEANNE R PETERSON3 | 603 STEVENSON ST NW BERTHOLD, ND 58718 | AFLAC | $150 | — | $150 | 0.12% |
| WANDA SNYDER3 Filed as: WANDA D SNYDER | 5609 POWERCAT PL MANHATTAN, KS 66503 | AFLAC | $148 | — | $148 | 0.12% |
| JEFFREY L GODWIN3 | 2331 CAPSTONE CT ROCKY MOUNT, NC 27804 | AFLAC | $143 | — | $143 | 0.12% |
| BRYAN MURPHY3 Filed as: BRYAN J MURPHY | 2436 CRIPPLE CREEK DR SAINT LOUIS, MO 63129 | AFLAC | $133 | $8 | $141 | 0.11% |
| PEAK INC3 | 1130 S BURR STE 300 PO BOX 514 MITCHELL, SD 57301 | AFLAC | $138 | — | $138 | 0.11% |
| LAUREN E WEIBERT3 | 734 RELIANCE DR FRANKLIN, TN 37067 | AFLAC | $120 | — | $120 | 0.10% |
| KATIE GUNDERSON3 | 3817 MORMON COULEE RD STE A LA CROSSE, WI 54601 | AFLAC | $113 | — | $113 | 0.09% |
| LL BERRY LTD3 | 2456 32ND STREET WEST BILLINGS, MT 59102 | AFLAC | $105 | — | $105 | 0.09% |
| ELLIE PAPINEAU LLC3 | 739 ALDRICH ST DICKINSON, ND 58601 | AFLAC | $104 | — | $104 | 0.08% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 215 N. MAIN ST. #800 DAVENPORT, IA 52801 | NATIONAL UNION FIRE | $3K | — | $3K | 5.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 800 MAIN STREET DUBUQUE, IA 52001 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $8K | — | $8K | 15.19% |
| RESERVE NATIONAL INSURANCE COMPANY3 | 601 E. BRITTON ROAD OKLAHOMA CITY, OK 73114 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 6.84% |
| BUTLER INSURANCE SERVICE INC3 | PO BOX 389 DUBUQUE, IA 52004 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.54% |
| BUTLER INSURANCE SERVICE INC3 | PO BOX 3310 DAVENPORT, IA 528083310 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $825 | — | $825 | 3.21% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | PO BOX 28 DUBUQUE, IA 52004 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | $104 | $1K | 11.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $811 | — | $811 | 15.44% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | PO BOX 28 DUBUQUE, IA 52004 | HARTFORD LIFE AND ACCIDENT | $228 | — | $228 | 4.34% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $0 | $100 | $100 | 1.90% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $167K |
| COTTINGHAM & BUTLER INS SRVCS INC EIN 42-0198040 BROKER | Other commissions Service code 55 | — | $28K |
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 | 289 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 460 | $11K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 415 | $26K |
| Life insurance(4 contracts, 4 carriers) | AFLAC | 238 | $182K |
| Other | NATIONAL UNION FIRE | 285 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 460 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.