| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT RD URBANDALE, IA 503232317 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $16K | $16K | 3.02% |
| ACRISURE LLC3 Filed as: ACRISURE,LLC | PO BOX 1788 GRAND RAPIDS, MI 495011788 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $10K | $10K | 2.01% |
| QCC INSURANCE COMPANY5 | 1901 MARKET ST PHILADELPHIA, PA 19103 | QCC INSURANCE COMPANY | — | $215K | $215K | 43.21% |
| DAN SHUTT- GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | QCC INSURANCE COMPANY | $33K | $0 | $33K | 6.52% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $11K | $0 | $11K | 5.72% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIR OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $7K | $2K | $9K | 4.68% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $3K | $2K | $5K | 2.62% |
| JASON DENNIS HOSEK3 | 700 WILD PINE CT SPRINGVILLE, IA 52336 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $2K | $0 | $2K | 1.23% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $2K | $102 | $2K | 0.90% |
| KIMBERLY LEWIS3 | 13911 JOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1K | $35 | $1K | 0.78% |
| FIRST AMERICAN INSURANCE3 | 2621 W US HWY 30 GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $809 | $0 | $809 | 0.42% |
| RICHARD G MCGOWAN3 | 1716 N 59TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $570 | $13 | $583 | 0.30% |
| DUSTIN LEE CLAIR3 | 4814 M AVE NW CEDAR RAPIDS, IA 52405 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $196 | $0 | $196 | 0.10% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRL SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $188 | $0 | $188 | 0.10% |
| BARBARA MARIE MCDONALD3 | 1630 TIMBER CT SE CEDAR RAPIDS, IA 52403 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $182 | $0 | $182 | 0.09% |
| EDGHILL ENTERPRISES LLC3 | 2701 N 70TH ST APT D87 LINCOLN, NE 68507 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $76 | $8 | $84 | 0.04% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $30 | $0 | $30 | 0.02% |
| MAMIE A STILES3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $6 | $0 | $6 | 0.00% |
| DEAN W FORNOFF3 | 16041 BUFFALO RD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $3 | $0 | $3 | 0.00% |
| JOEL KEITH STRADINGER3 | 2514 N 69TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $2 | $0 | $2 | 0.00% |
| TODD MICHAEL COHOE3 | 2835 SOUTH 1036TH ST OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1 | $0 | $1 | 0.00% |
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 | 890 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 890 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCC INSURANCE COMPANY | 456 | $498K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 890 | $514K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 890 | $514K |
| Stop-loss / reinsurancereinsurance | QCC INSURANCE COMPANY | 456 | $498K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE CO. | 294 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 890 | — |
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.