| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | PRINCIPAL LIFE INSURANCE COMPANY | $62K | $558 | $63K | 12.46% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 0.70% |
| QCC INSURANCE COMPANY5 | 1901 MARKET STREET PHILADELPHIA, PA 19103 | QCC INSURANCE COMPANY | $0 | $177K | $177K | 49.52% |
| DAN SHUTT-GROUP BENEFITS LTD3 Filed as: DAN SHUTT - GROUP BENEFITS LTD. | 12006 RIDGEMOUNT DR URBANDALE, IA 50323 | QCC INSURANCE COMPANY | $30K | $0 | $30K | 8.40% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMOUNT DR URBANDALE, IA 50323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 4.91% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $1K | $8K | 4.44% |
| HOVIE AGENCY LLC3 | 11261 WIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $472 | $2K | 1.27% |
| KIMBERLY LEWIS3 | 13911 SOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $26 | $1K | 0.78% |
| FIRST AMERICAN INSURANCE3 | 2621 W US HWY 30 GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.68% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $60 | $1K | 0.67% |
| JASON DENNIS HOSEK3 | 606 BROADWAY ST SPRINGVILLE, IA 52336 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.64% |
| RICHARD G MCGOWAN3 | 1716 N 59TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $713 | $4 | $717 | 0.41% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRAIL SIOUX FALLS, IA 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $0 | $233 | 0.13% |
| DUSTIN LEE CLAIR3 | 4814 M AVE NW CEDER RAPIDS, IA 52405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $100 | $190 | 0.11% |
| EDGHILL ENTERPRISES LLC3 | 2701 NORTH 70TH ST - APT 87 LINCOLN, NE 68507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | $15 | $162 | 0.09% |
| BARBARA MARIE MCDONALD3 | 1630 TIMBER COURT SE CEDAR RAPIDS, IA 52403 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $9 | $99 | 0.06% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | $0 | $63 | 0.04% |
| JOEL KEITH STRADINGER3 | 2514 N 69TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $0 | $55 | 0.03% |
| MA STILES LLC3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| DEAN W FORNOFF3 | 16041 BUFFALO RD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| JOAN C MCGILL3 | 6109 N 295TH ST VALLEY, NE 68064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| TODD BURKE3 Filed as: TODD MICHAEL COHOE | 2835 S 1036TH ST OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $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 | 892 | 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) | 892 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCC INSURANCE COMPANY | 416 | $357K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 892 | $506K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 892 | $506K |
| Stop-loss / reinsurancereinsurance | QCC INSURANCE COMPANY | 416 | $357K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 288 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 892 | — |
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.