| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | TWO PIERCE PLACE ITASCA, IL 60143 | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | $4K | — | $4K | 2.33% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRAIL SIOUX FALLS, IA 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 8.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | PO BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $532 | $5K | 5.01% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $428 | $2K | 2.10% |
| ROBERT ELLIS3 Filed as: ROBERT EUGENE ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $389 | $2K | 1.98% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $816 | $39 | $855 | 0.83% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $212 | — | $212 | 0.21% |
| DEAN W FORNOFF3 Filed as: DEAN FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.04% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY INC | 500 W 13TH STREET FORT WORTH, TX 76102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.02% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.01% |
| DARIN POTTS3 | 100 DETERING STREET APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| JON SCOTT SWARTZENDRUBER3 | 1805 5TH AVENUE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 51106 | SUN LIFE ASSURANCE COMPANY OF CANADA | $13K | — | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 51106 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 10.00% |
| SELECT NETWORKS3 | 317 6TH AVENUE SUITE 1440 DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 11.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4280 SERGEANT ROAD SIOUX CITY, IA 51106 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 51106 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 172 | $2.6M |
| Dental | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 205 | $161K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 423 | $34K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 285 | $183K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 115 | $103K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 285 | $84K |
| Prescription drug(2 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 172 | $2.6M |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 285 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 423 | — |
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.