| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 503232317 | PRINCIPAL LIFE INSURANCE COMPANY | $43K | $14K | $58K | 12.09% |
| QCC INSURANCE COMPANY5 | 1901 MARKET STREET PHILADELPHIA, PA 19103 | QCC INSURANCE COMPANY | $0 | $172K | $172K | 45.70% |
| DAN SHUTT-GROUP BENEFITS LTD3 Filed as: DAN SHUTT - GROUP BENEFITS LTD | 12006 RIDGEMONT DR URBANDALE, IA 50323 | QCC INSURANCE COMPANY | $30K | $0 | $30K | 7.98% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 4.54% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIR OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $1K | $8K | 4.17% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $945 | $3K | 1.46% |
| JASON DENNIS HOSEK3 | 700 WILD PINE CT SPRINGVILLE, IA 52336 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.96% |
| FIRST AMERICAN INSURANCE3 | 2621 W US HWY 30 GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.58% |
| KIMBERLY LEWIS3 | 13911 JOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $995 | $30 | $1K | 0.55% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $791 | $37 | $828 | 0.45% |
| RICHARD G MCGOWAN3 | 1716 N 59TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $570 | — | $570 | 0.31% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRL SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $234 | — | $234 | 0.13% |
| DUSTIN LEE CLAIR3 | 4814 M AVE NW CEDAR RAPIDS, IA 52405 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $35 | $178 | 0.10% |
| BARBARA MARIE MCDONALD3 | 1630 TIMBER CT SE CEDAR RAPIDS, IA 52403 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | — | $143 | 0.08% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.03% |
| EDGHILL ENTERPRISES LLC3 | 2701 N 70TH ST APT D87 LINCOLN, NE 68507 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 0.02% |
| JOEL KEITH STRADINGER3 | 2514 N 69TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.01% |
| MA STILES LLC3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| DEAN W FORNOFF3 | 16041 BUFFALO RD SPRING FIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| JOAN C MCGILL3 | 6109 N 295TH ST VALLEY, NE 68064 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| TODD BURKE3 Filed as: TODD MICHAEL COHOE | 2835 SOUTH 1036TH ST OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BENECOMM RESOURCES INC3 | 8009 GOODMON DR URBANDALE, IA 50322 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| BRYON A BROWDER3 | 75 NW 57TH PL DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $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 | 718 | 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) | 718 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCC INSURANCE COMPANY | 406 | $376K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 718 | $477K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 718 | $477K |
| Stop-loss / reinsurancereinsurance | QCC INSURANCE COMPANY | 406 | $376K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 271 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 718 | — |
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.