| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 601433141 | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $29K | — | $29K | 1.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE ITASCA, IL 60143 | WELLMARK HEALTH PLAN OF IOWA | $5K | — | $5K | 2.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4064 COLONY RD, SUITE 450 CHARLOTTE, NC 28211 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.50% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, STE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | -$36 | -$36 | -0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2 PIERCE PLAZA, 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF IOWA | $3K | $452 | $3K | 9.35% |
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 | 140 | 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) | 140 | 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 | 117 | $1.8M |
| Dental | DELTA DENTAL OF IOWA | 62 | $34K |
| Vision | HUMANA INSURANCE COMPANY | 34 | $6K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $89K |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 117 | $1.5M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.