| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY, INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $47K | $0 | $47K | 1.01% |
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY, INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $0 | $9K | 9.75% |
| ARTHUR VANDER WILT3 Filed as: ARTHUR VANDERWILT | PO BOX 248 SHELDON, IA 51201 | AFLAC | $3K | $0 | $3K | 4.74% |
| JULIE A MANN3 Filed as: JULIE A. MANN AND OTHER AGENTS | 5001 SERGEANT ROAD SUITE 50 SIOUX CITY, IA 51106 | AFLAC | $2K | $3 | $2K | 3.55% |
| STEVEN L. VONK3 | 1602 10TH STREET ROCK VALLEY, IA 51247 | AFLAC | $1K | $0 | $1K | 2.02% |
| AMY R JAGER3 Filed as: AMY R. JAGER | 221 NORTH WASHINGTON AVENUE SHELDON, IA 51201 | AFLAC | $698 | $15 | $713 | 1.05% |
| AMY HANSEN & ASSOCIATES, INC.3 Filed as: AMY HANSEN AND ASSOCIATES, INC. | PO BOX 406 SPENCER, IA 51301 | AFLAC | $675 | $3 | $678 | 1.00% |
| MARK FRIEHE3 Filed as: MARK E. FRIEHE | 11329 P STREET SUITE 120 OMAHA, NE 68137 | AFLAC | $496 | $0 | $496 | 0.73% |
| VAN ENGELENHOVEN AGENCY INC3 Filed as: VAN ENGELENHOVEN AGENCY, INC. | 122 CENTRAL AVENUE SW ORANGE CITY, IA 51041 | AFLAC | $445 | — | $445 | 0.66% |
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 | 274 | 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) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 253 | $4.6M |
| Dental | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 243 | $157K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 491 | $43K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 369 | $97K |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 253 | $4.6M |
| Other(2 contracts, 2 carriers) | AFLAC | 295 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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.