| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 71696 CHICAGO, IL 606941696 | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | $4K | $0 | $4K | 2.14% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRAIL SIOUX FALLS, IA 51108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 6.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | PO BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $458 | $6K | 4.83% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.64% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $52 | $2K | 1.51% |
| ROBERT ELLIS3 Filed as: ROBERT EUGENE ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $939 | $22 | $961 | 0.72% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $844 | $23 | $867 | 0.65% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $151 | $0 | $151 | 0.11% |
| DEAN W FORNOFF3 Filed as: DEAN FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 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 | $17 | — | $17 | 0.01% |
| DARIN POTTS3 | 100 DETERING STREET APT 2128 HOUSTON, TX 77007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 51106 | RELIANCE MATRIX | $13K | $0 | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1 WEST 4TH STREET SUITE 1300 CINCINNATI, OH 45202 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| WELLMARK INC3 Filed as: WELLMARK, INC | 1331 GRAND AVANUE DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 4280 SERGEANT ROAD SUITE 200 SIOUX CITY, IA 51106 | RELIANCE MATRIX | $8K | — | $8K | 19.61% |
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 | 227 | 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) | 229 | 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 | 197 | $3.2M |
| Dental | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 244 | $199K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 507 | $50K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 307 | $210K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 268 | $143K |
| Long-term disability | RELIANCE MATRIX | 307 | $90K |
| Prescription drug(2 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 197 | $3.2M |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 307 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 507 | — |
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.