| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA5 Filed as: WELLMARK BLUE CROSS AND BLUE SHIELD | 636 GRAND AVE SUITE 24 DES MOINES, IA 50309 | WELLMARK BLUE CROSS NAD BLUE SHIELD OF IOWA | — | $304K | $304K | 6.56% |
| SELF INSURED INSURANCE COMPANY5 | 300 SECURITY BLDG 151 WEST 8TH DUBUQUE, IA 52005 | SELF INSURED SERVICES COMPANY | — | $17K | $17K | 15.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 400 HWY 169 SOUTH ST LOUIS PARK, MN 55426 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 10.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA | PO BOX 203373 DALLAS, TX 75320 | HARTFORD LIFE AND ACCIDENT | $594 | — | $594 | 2.49% |
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 | 457 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS NAD BLUE SHIELD OF IOWA | 469 | $4.6M |
| Dental | SELF INSURED SERVICES COMPANY | 440 | $114K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 541 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.