| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BETTY G BRUNSVOLD3 | 802 S MILL ST LAKE MILLS, IA 50450 | AFLAC | $8K | $65 | $8K | 4.71% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: CATHERINE A RIGGS | 314 HOWARD ST ALBURNETT, IA 52202 | AFLAC | $4K | $71 | $4K | 2.24% |
| VARIOUS BROKERS 100 COMMISSIONS3 | DETAIL AVAILABLE UPON REQUEST NORTH LIBERTY, IA 52317 | AFLAC | $3K | $99 | $3K | 1.98% |
| SARA LANG3 | PO BOX 232 TIFFIN, IA 52340 | AFLAC | $3K | $138 | $3K | 1.91% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS INSURANCE INC | 465 NORTHLAND AVE NE SUITE 201 CEDAR RAPIDS, IA 52402 | AFLAC | $3K | $82 | $3K | 1.88% |
| SHARON R LUCARELLI3 | 12725 BENNINGTON COMMON LN SAINT LOUIS, MO 63146 | AFLAC | $3K | $109 | $3K | 1.67% |
| MICHELLE FODREY3 | 332 S GRACE ST LOMBARD, IL 60148 | AFLAC | $2K | $49 | $2K | 1.29% |
| MARIE L FELLOWS3 | 1180 KENNEDY PKWY APT 208 CORALVILLE, IA 52241 | AFLAC | $2K | — | $2K | 0.96% |
| LOREN MEYER3 | 2604 WEST EUCLID AVENUE INDIANOLA, IA 50125 | AFLAC | $1K | $102 | $2K | 0.91% |
| RACHEL THERIOT CURRY3 | 109 WINGED FOOT DR BROUSSARD, LA 70518 | AFLAC | $1K | — | $1K | 0.74% |
| STEVEN G JOHNSON3 | 35989 HIGHWAY 69 STE C FOREST CITY, IA 50436 | AFLAC | $1K | $11 | $1K | 0.71% |
| TINA M KECK3 Filed as: TINA KECK | 440 LOWELL ST DUBUQUE, IA 52001 | AFLAC | $1K | — | $1K | 0.66% |
| THE SHARON MILLER AGENCY LLC3 | PO BOX 15 BELMOND, IA 50421 | AFLAC | $1K | $5 | $1K | 0.63% |
| CORY D NELSON3 | 215 HIGHWAY 965 NE STE 3 NORTH LIBERTY, IA 52317 | AFLAC | $913 | $46 | $959 | 0.57% |
| ATHAR QURESHI3 | 6535 RODGERS DR WILLOWBROOK, IL 60527 | AFLAC | $905 | — | $905 | 0.54% |
| LANDON JOHNSEY3 | 307 HIGHLAND PARK LANE LAFAYETTE, LA 70508 | AFLAC | $712 | $21 | $733 | 0.44% |
| JUDITH CARRILLO3 | 2646 HARRISON STREET OMAHA, NE 68147 | AFLAC | $625 | $11 | $636 | 0.38% |
| LISA M SCHUMACHER3 Filed as: LISA SCHUMACHER | 10 HERON CT LAKE IN THE HILLS, IL 60156 | AFLAC | $616 | — | $616 | 0.37% |
| BRAD BIEL3 Filed as: BRAD JOHNSON | 1815 14TH ST NW STE C ROCHESTER, MN 55901 | AFLAC | $601 | — | $601 | 0.36% |
| THE SHARON MILLER AGENCY LLC3 Filed as: SHARON MILLER | PO BOX 15 BELMOND, IA 50421 | AFLAC | $548 | $9 | $557 | 0.33% |
| CATHERINE M AULBACH3 | 11116 S TOWNE SQ SAINT LOUIS, MO 63123 | AFLAC | $399 | $22 | $421 | 0.25% |
| GAIL BARNARD3 | 1178 WADE ST HIGHLAND PARK, IL 60035 | AFLAC | $313 | $66 | $379 | 0.23% |
| BRYAN MURPHY3 Filed as: BRYAN J MURPHY | 2436 CRIPPLE CREEK DR SAINT LOUIS, MO 63129 | AFLAC | $298 | $15 | $313 | 0.19% |
| TYONIA N EGGERS3 | 102 BASS ST STORM LAKE, IA 50588 | AFLAC | $243 | $2 | $245 | 0.15% |
| MICHELLE KARCHER3 | 1070 HIGHWAY 18 ABILENE, KS 67410 | AFLAC | $241 | — | $241 | 0.14% |
| KEITH WILLIAM BELLE3 Filed as: KEITH BELLE | 302 LA RUE FRANCE STE 100 LAFAYETTE, LA 70508 | AFLAC | $234 | — | $234 | 0.14% |
| CATHY A BEST3 | 4604 31ST AVE MOLINE, IL 61265 | AFLAC | $197 | $16 | $213 | 0.13% |
| NANCY KINTZLE3 | 26201 212TH AVE DEHLI, IA 52223 | AFLAC | $205 | — | $205 | 0.12% |
| TERRELL & COMPANY INC3 | 4401 WESTOWN PKWY STE 350 WEST DES MOINES, IA 50266 | AFLAC | $187 | $10 | $197 | 0.12% |
| BETTY L WALKER-COWAN3 | 216 E MAPLE AVE OTTUMWA, IA 52501 | AFLAC | $195 | — | $195 | 0.12% |
| CATHRINE FLEISCHHACKER3 | 606 110TH ST OTTOSEN, IA 50570 | AFLAC | $193 | — | $193 | 0.12% |
| ERIC SHATZ3 | 10004 HARDY DR OVERLAND PARK, KS 66212 | AFLAC | $185 | — | $185 | 0.11% |
| RONALD E KIRKLAND3 Filed as: RONALD D BEDDINGFIELD | 132 N ENGLEWOOD DR ROCKY MOUNT, NC 27804 | AFLAC | $129 | $51 | $180 | 0.11% |
| MICHAEL WARD3 | 10550 BARKLEY ST STE 203 OVERLAND PARK, KS 66212 | AFLAC | $142 | $32 | $174 | 0.10% |
| ALEX ESCALLIER3 | 17W535 SCHILLER ST VILLA PARK, IL 60181 | AFLAC | $173 | — | $173 | 0.10% |
| TONYA L REMLEY3 Filed as: TONYA REMLEY | 1225 E RIVER DR STE 302 DAVENPORT, IA 52803 | AFLAC | $168 | $3 | $171 | 0.10% |
| JANET ROSS3 | 320 N FENWAY AVE BARTLESVILLE, OK 74006 | AFLAC | $168 | — | $168 | 0.10% |
| THE TODD GROUP3 | 100 E 2ND ST UNIT 205 CEDAR FALLS, IA 50613 | AFLAC | $161 | — | $161 | 0.10% |
| MARY ANN KELLER3 Filed as: MARY KELLER | 1930 28TH ST SW MINOT, ND 58701 | AFLAC | $150 | — | $150 | 0.09% |
| GABRIEL MEJIA3 | 2320 14TH ST NW MINOT, ND 58703 | AFLAC | $147 | — | $147 | 0.09% |
| MONICA WHITE3 | 28876 DELTA AVE TREYNOR, IA 51575 | AFLAC | $146 | — | $146 | 0.09% |
| MELISSA MURRAY3 | 18390 GLENBRIDGE AVE LAKEVILLE, MN 55044 | AFLAC | $138 | — | $138 | 0.08% |
| BETH ZADOW3 | 1300 7TH PL N CLEAR LAKE, IA 50428 | AFLAC | $132 | — | $132 | 0.08% |
| GERALD A GREENEN3 | 2461 BARKDOLL RD NAPERVILLE, IL 60565 | AFLAC | $106 | $13 | $119 | 0.07% |
| KEVIN CARR3 | 800 W BENTON ST APT 103A IOWA CITY, IA 52246 | AFLAC | $110 | — | $110 | 0.07% |
| MARY E MINTON3 | 24230 W 61ST ST N ANDALE, KS 67001 | AFLAC | $105 | — | $105 | 0.06% |
| MICHELLE ALBEA3 | 11909 S 34TH ST BELLEVUE, NE 68123 | AFLAC | $103 | — | $103 | 0.06% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 215 N. MAIN ST. #800 DAVENPORT, IA 52801 | HCC LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| CGI - COMMERCIAL GROUP INTERMEDIARI | 19 ILLINOIS AVE. SCHAUMBURG, IL 60193 | HCC LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | 800 MAIN STREET DUBUQUE, IA 52001 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 14.52% |
| RESERVE NATIONAL INSURANCE COMPANY3 | 601 E. BRITTON ROAD OKLAHOMA CITY, OK 73114 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 8.19% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERVI | PO BOX 28 DUBUQUE, IA 52004 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $270 | $4K | 10.70% |
| BUTLER INSURANCE SERVICE INC3 | PO BOX 389 DUBUQUE, IA 52004 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $297K |
| COTTINGHAM & BUTLER INS SRVCS INC EIN 42-0198040 BROKER | Other commissions Service code 55 | — | $44K |
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 | 487 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 585 | $35K |
| Life insurance(4 contracts, 4 carriers) | AFLAC | 637 | $249K |
| Other | HCC LIFE INSURANCE COMPANY | 482 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 637 | — |
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.