| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHAWN J KEELER3 | 2209 1ST AVE NAPOLEONVILLE, LA 70390 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $17K | — | $17K | 18.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 300 CHERAPA PLACE STE 601 SIOUX FALLS, SD 57103 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 8.66% |
| KEELER & ASSOCIATES3 | 2209 1ST AVE PLATTSMOTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 2.15% |
| ANTHONY C BUECHLER3 | 1203 COLONIAL CIRCLE OMAHA, NE 68046 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $165 | — | $165 | 0.18% |
| SHEILA A PETERSON3 | 2209 1ST AVE PLATTSMOTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | — | $18 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELLMARK BLUE CROSS AND BLUE SHEILD EIN 42-0318333 INSURANCE PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $327K |
| HOWALT & MCDOWELL INSURANCE EIN 36-1436000 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 300 NORTH CHERAPA PLACE SIOUX FALLS, SD 57103 | $38K |
| DELTA DENTAL OF IOWA EIN 42-0959302 INSURANCE PROVIDER | Contract Administrator; Claims processing Service code 12 | — | $36K |
| SELERIX SYSTEMS, INC. EIN 80-0236699 WEBSITE MANAGER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
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 | 690 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 696 | 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 | 645 | $4.3M |
| Dental | DELTA DENTAL OF IOWA | 646 | $328K |
| Vision | VISION SERVICE PLAN | 495 | $92K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 975 | $71K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 757 | $80K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 757 | $58K |
| Stop-loss / reinsurancereinsurance | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 645 | $4.2M |
| Other(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 969 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 975 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.