| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID H. BURKE3 | 222 THIRD ST SE, STE 306 CEDAR RAPIDS, IA 52401 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EASTERN IOWA FRINGE BENEFIT FUNDS EIN 42-1395230 NONE | Contract Administrator Service code 13 | 1831 16TH AVE SW CEDAR RAPIDS, IA 52404 | $231K |
| DAY RETTIG PEIFFER, PC EIN 42-1386412 NONE | Legal Service code 29 | PO BOX 2877 CEDAR RAPIDS, IA 52406 | $52K |
| MIDLANDS CHOICE INC EIN 47-0804331 NONE | Contract Administrator Service code 13 | 8420 W DODGE RD, STE 210 OMAHA, NE 68114 | $40K |
| FOSTER & FOSTER NONE | Consulting (general) Service code 16 | ONE OAKBROOK TERRACE, SUITE 812 OAK BROOK TERRACE, IL 60181 | $36K |
| MEKETA INVESTMENT GROUP EIN 35-2323525 NONE | Investment advisory (plan) Service code 27 | 525 W. MONROE STREET, SUITE 560 CHICAGO, IL 60661 | $25K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Contract Administrator Service code 13 | 115 E HIGHLAND AVE ELGIN, IL 60120 | $24K |
| LWBJ, LLP EIN 42-1462849 NONE | Accounting (including auditing) Service code 10 | 4200 UNIVERSITY AVE, SUITE 410 WEST DES MOINES, IA 50266 | $15K |
| BRADLEY HAUGE, CPA NONE | Accounting (including auditing) Service code 10 | 4807 MARY GREEN CT, NE CEDAR RAPIDS, IA 52411 | $13K |
| ASMED HEALTH EIN 27-4189010 NONE | Contract Administrator Service code 13 | 3230 W COMMERICAL BLVD 350 FT LAUDERDALE, FL 33309 | $12K |
| CEDAR RAPIDS PHO EIN 42-1445014 NONE | Contract Administrator Service code 13 | 722 5TH AVE SE CEDAR RAPIDS, IA 52401 | $11K |
| INDEPENDENT EMPLOYEE BENEFIT CORP EIN 36-3097979 NONE | Contract Administrator Service code 13 | 28 N 1ST ST GENEVA, IL 60134 | $7K |
| ROMOLO & ASSOCIATES EIN 37-1077733 NONE | Accounting (including auditing) Service code 10 | 1700 W. LUTHY DRIVE PEORIA, IL 61615 | $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 | 710 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 733 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 680 | $16K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 727 | $413K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 680 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 727 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.