| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMERCIAL GROUP INTERMEDIARIES3 | 16 EXECUTIVE CT., SUITE 4 SOUTH BARRINGTON, IL 60010 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $24K | — | $24K | 5.00% |
| COMMERCIAL GROUP INTERMEDIARIES3 | 16 EXECUTIVE CT., SUITE 4 SOUTH BARRINGTON, IL 60010 | THE UNION LABOR LIFE INSURANCE COMPANY | $442 | — | $442 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS MANAGEMENT GROUP INC. EIN 20-0188125 NONE | Plan Administrator Service code 14 | 150 1ST AVENUE EAST CEDAR RAPIDS, IA 52401 | $126K |
| HMC COMPANIES EIN 75-3189468 NONE | Other services Service code 49 | 181 COMMODORE DR JUPITER, FL 33477 | $33K |
| JAMES GALLERY & ASSOCIATES EIN 20-0188135 NONE | Consulting (general) Service code 16 | 903 COMMERCE DR OAK BROOK, IL 60523 | $27K |
| DAY RETTIG PEIFFER, PC EIN 42-1386412 NONE | Legal Service code 29 | 150 FIRST AVE NE, STE 415 CEDAR RAPIDS, IA 52401 | $27K |
| LWBJ,LLP EIN 42-1462849 NONE | Accounting (including auditing) Service code 10 | 4200 UNIVERSITY AVE., SUITE 410 WEST DES MOINES, IA 50266 | $19K |
| WELLS FARGO BANK, N.A. EIN 94-1347393 NONE | Investment management fees paid directly by plan Service code 51 | PO BOX 20160 LONG BEACH, CA 90801 | $16K |
| BRADLEY HAUGE, CPA NONE | Accounting (including auditing) Service code 10 | 4807 MARY GREEN CT. NE CEDAR RAPIDS, IA 52411 | $11K |
| DELTA DENTAL EIN 36-2612058 NONE | Claims processing Service code 12 | — | $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 | 388 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 388 | $3.6M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 371 | $9K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 376 | $482K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 371 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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.
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.