| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 10100 INNOVATION DRIVE, 2ND FLOOR MIAMISBURG, OH 45342 | UNITEDHEALTHCARE INSURANCE COMPANY | $16K | $0 | $16K | 7.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $0 | $5K | 2.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS/HRH | UNKNOWN DECATUR, IL 62526 | DELTA DENTAL OF ILLINOIS | $4K | $0 | $4K | 2.45% |
| USI INSURANCE SERVICES LLC3 | 6900 COLLEGE BOULEVARD SUITE 520 OVERLAND PARK, KS 66211 | DELTA DENTAL OF ILLINOIS | $2K | $0 | $2K | 1.19% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO STREET, SUITE 412 WICHITA, KS 67202 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.98% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | ALLSTATE WORKPLACE DIVISION | $241 | $0 | $241 | 5.20% |
| USI INSURANCE SERVICES LLC | PO BOX 62889 VIRGINIA BEACH, VA 23466 | ALLSTATE WORKPLACE DIVISION | $207 | $0 | $207 | 4.47% |
| COLE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | ALLSTATE WORKPLACE DIVISION | $124 | $0 | $124 | 2.68% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | ALLSTATE WORKPLACE DIVISION | $117 | $0 | $117 | 2.52% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $101 | $0 | $101 | 10.10% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO STREET, SUITE 402 SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $90 | $0 | $90 | 9.00% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOEKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $49 | $0 | $49 | 4.90% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $49 | $0 | $49 | 4.90% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.80% |
No Schedule C service providers reported on this filing.
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 | 368 | 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) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 263 | $182K |
| Vision | VISION SERVICE PLAN | 231 | $27K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 368 | $223K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 368 | $223K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 368 | $223K |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 368 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 368 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.