| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE BENEFIT PLANNING, LLC3 Filed as: INNOVATIVE BENEFIT CONSULTANTS | 412 WATER STREET SIOUX CITY, IA 51103 | DELTA DENTAL OF IOWA | $2K | $559 | $3K | 7.43% |
| SYPERSMA, GINA3 Filed as: SYPERSMA GINA | 412 WATER STREET SIOUX CITY, IA 51103 | KANSAS CITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $74K |
| INNOVATIVE BENEFIT CONSULTANTS INC EIN 20-3051128 BROKER | Other commissions Service code 55 | — | $35K |
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 | 163 | 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) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF IOWA | 163 | $39K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 166 | $27K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 166 | $27K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 156 | $241K |
| Other | KANSAS CITY LIFE INSURANCE COMPANY | 166 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.