| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZACH CORPORATION3 | 66 PROGRESS AVE WATERLOO, IA 50701 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $48K | — | $48K | 1.43% |
| PEDERSEN DOWIE CLABBY3 | 3927 UNIVERSITY AVE PO BOX 3597 WATERLOO, IA 507015641 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $3K | $23K | 13.16% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 WATERLOO, IA 507042597 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.79% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 WATERLOO, IA 507042597 | STANDARD INSURANCE COMPANY | $692 | — | $692 | 0.64% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | DBA PDCM INSURANCE PO BOX 2597 WATERLOO, IA 50704 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 7.33% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | DBA PDCM INSURANCE PO BOX 2597 WATERLOO, IA 50704 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $1K | $10K | 17.42% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | DBA PDCM INSURANCE PO BOX 2597 WATERLOO, IA 50704 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $1K | $6K | 11.54% |
| GROUP BENEFITS DESIGN CORPORATION3 | 622 PROGRESS AVE PO BOX 2597 WATERLOO, IA 50701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| PEDERSEN DOWIE CLABBY & MCCAUSLAND3 | PO BOX 2597 WATERLOO, IA 507042597 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
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 | 290 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 295 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 305 | $3.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 436 | $172K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 424 | $38K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 361 | $173K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 361 | $48K |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 305 | $3.4M |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 361 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.