| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PARTNERS HEALTH INSURANCE3 Filed as: PARTNERS HEALTH INSURANCE LLC | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | $49K | $0 | $49K | 1.04% |
| ARTHUR VANDER WILT3 Filed as: ARTHUR VANDERWILT | PO BOX 248 SHELDON, IA 51201 | AFLAC | $6K | $69 | $6K | 8.05% |
| STEVEN L. VONK3 | 1602 10TH STREET ROCK VALLEY, IA 51247 | AFLAC | $2K | $0 | $2K | 2.39% |
| JANE POTTEBAUM3 Filed as: JANE M. POTTEBAUM AND OTHER AGENTS | 19258 HAWTHORNE AVENUE CARROLL, IA 51401 | AFLAC | $1K | $22 | $1K | 1.63% |
| TESS BRANT3 Filed as: TESS M. BRANT | 1509 EAST 18TH STREET SPENCER, IA 51301 | AFLAC | $730 | $16 | $746 | 0.95% |
| MARK FRIEHE3 Filed as: MARK E. FRIEHE | 8404 WEST CENTER ROAD, SUITE 112 OMAHA, NE 68124 | AFLAC | $660 | $0 | $660 | 0.84% |
| TYONIA EGGERS INC3 Filed as: TYONIA EGGERS INC. | 102 BASS STREET STORM LAKE, IA 50588 | AFLAC | $641 | $16 | $657 | 0.84% |
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | AFLAC | $627 | $0 | $627 | 0.80% |
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY, INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | EMC NATIONAL LIFE | $7K | $0 | $7K | 10.00% |
| SELECT NETWORKS3 | 317 6TH AVENUE, SUITE 1440 DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | $0 | $5K | 11.01% |
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.56% |
| VONK INSURANCE AGENCY4 | 1602 10TH STREET ROCK VALLEY, IA 51247 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $977 | $0 | $977 | 9.70% |
| VAN ENGELENHOVEN AGENCY INC4 Filed as: VAN ENGELENHOVEN AGENCY INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $723 | $0 | $723 | 7.17% |
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 | 324 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 274 | $4.7M |
| Dental | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 274 | $4.7M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 517 | $44K |
| Life insurance | EMC NATIONAL LIFE | 288 | $72K |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 274 | $4.7M |
| Other(3 contracts, 3 carriers) | AFLAC | 331 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 517 | — |
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.