| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 601433141 | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | $7K | — | $7K | 5.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 511064647 | UNION SECURITY INSURANCE COMPANY | $11K | $2K | $14K | 11.82% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $358 | $6K | 7.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | PO BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $86 | $4K | 4.80% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $464 | $2K | 2.10% |
| ROBERT ELLIS3 Filed as: ROBERT EUGENE ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $378 | $2K | 1.96% |
| DALE I DAVIS3 Filed as: DALE JOHNSTON | 1612 M AVENUE MILFORD, IA 51351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $872 | $68 | $940 | 1.06% |
| JERRY A EDGAR3 | 7021 S 38TH STREET LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $819 | $23 | $842 | 0.95% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $355 | — | $355 | 0.40% |
| DEAN W FORNOFF3 Filed as: DEAN FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $1 | $125 | 0.14% |
| CRISS BUTLER3 | 4924 EASTRIDGE DRIVE OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | — | $62 | 0.07% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.03% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE #400 BLOOMINGTON, MN 55437 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JON SCOTT SWARTZENDRUBER3 | 600 HIGHWAY 169 SOUTH MINNEAPOLIS, MN 55426 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| DARIN POTTS3 | 510 BERING DRIVE HOUSTON, TX 77057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| SELECT NETWORKS3 | 317 6TH AVENUE SUITE 1440 DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4280 SERGEANT ROAD SIOUX CITY, IA 51106 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.94% |
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 | 164 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 171 | $1.8M |
| Dental | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 174 | $136K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 280 | $24K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 229 | $205K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 106 | $89K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 229 | $116K |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 171 | $1.8M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 229 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.