| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INNOVATIVE BENEFIT PLANNING, LLC3 Filed as: INNOVATIVE BENEFIT CONSULTANTS INC. | 412 WATER ST. SIOUX CITY, IA 51103 | WELLMARK BCBS | $43K | — | $43K | 2.12% |
| STUART LEE3 | INNOVATIVE BENEFIT CONSULTANTS 412 WATER ST SIOUX CITY, IA 51103 | DELTA DENTAL OF SOUTH DAKOTA | $3K | — | $3K | 1.39% |
| INNOVATIVE BNFT CONSULTANTS3 | 412 WATER STREET SIOUX CITY, IA 51103 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $130 | $1K | 4.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | P O BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $981 | $28 | $1K | 3.31% |
| MATTHES J CLAUSEN3 Filed as: MATTHES J. CLAUSEN | 23088 JADE AVE MERRILL, IA 51038 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $649 | — | $649 | 2.13% |
| ROBERT ELLIS3 Filed as: ROBERT EUGENE ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $310 | $74 | $384 | 1.26% |
| STEPHEN CORRIVEAU3 Filed as: STEPHEN J SALEM | 1506 COUNTRY CLUB DR ELK POINT, SD 57025 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $239 | $131 | $370 | 1.21% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $226 | $91 | $317 | 1.04% |
| DUANNE GOTTSCH3 | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $91 | $0 | $91 | 0.30% |
| GARY L HOLTROP3 Filed as: GARY L. HOLTROP | BOX 218 IRETON, IA 51027 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $0 | $69 | 0.23% |
| SCOTT SWARTZENDRUBER3 | 5701 KENTUCKY AVE NORTH CRYSTAL, MN 55428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.06% |
| DEAN W FORNOFF3 Filed as: DEAN FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| JULIA C SHARP3 Filed as: JULIA SHARP | 5810 N 166TH STREET OMAHA, NE 68116 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| RICHARD G MCGOWN3 Filed as: RICHARD MCGOWAN | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| INNOVATIVE BENEFIT PLANNING, LLC3 Filed as: INNOVATIVE BENEFIT CONSULTANTS | 412 WATER ST. SIOUX CITY, IA 51103 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| SELECT NETWORKS3 | 317 6TH AVENUE DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 8.00% |
| INNOVATIVE BNFT CONSULTANTS3 | 412 WATER STREET SIOUX CITY, IA 51103 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $565 | — | $565 | 8.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CNOS, PC EMPLOYER | Employee (plan) Service code 30 | 575 SIOUX POINT RD DAKOTA DUNES, SD 57049 | $136K |
| CVS CAREMARK 02921 | Employee (plan) Service code 30 | 105 MALL BLVD MONROEVILLE, PA 15146 | $67K |
| CVS CAREMARK | Employee (plan) Service code 30 | 11162 RENNER RD LENEXA, KS 66219 | $50K |
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 | 212 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 42 | $30K |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 493 | $200K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 294 | $26K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 212 | $37K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 42 | $30K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 205 | $82K |
| Other(2 contracts, 2 carriers) | WELLMARK BCBS | 212 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 493 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.