| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INC | 4321 E 60TH STREET DAVENPORT, IA 52807 | AVERA HEALTH PLANS, INC. | $27K | — | $27K | 2.93% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INC | 4321 E 60TH ST DAVENPORT, IA 52807 | AVERA HEALTH PLANS, INC | $12K | — | $12K | 4.20% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 57701 | DELTA DENTAL | $1K | — | $1K | 2.55% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURORS INC | PO BOX 1300 RAPID CITY, SD 577091300 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.59% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INS SVCS LLC | 4321 E 60TH ST DAVENPORT, IA 528073505 | PRINCIPAL LIFE INSURANCE COMPANY | $576 | — | $576 | 2.77% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 57701 | DELTA DENTAL | $979 | — | $979 | 4.84% |
| WESTERN DAKOTA INSURORS3 | 816 5TH ST RAPID CITY, SD 577013708 | VISION SERVICE PLAN | $749 | — | $749 | 7.50% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURORS INC | PO BOX 1300 RAPID CITY, SD 577091300 | PRINCIPLE LIFE INSURANCE | $1K | — | $1K | 14.02% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INSURANCE SERVICES, LLC | 4321 E 60TH ST. DAVENPORT, IA 528073505 | PRINCIPLE LIFE INSURANCE | $370 | — | $370 | 4.01% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 577013708 | VISION SERVICE PLAN | $396 | — | $396 | 10.01% |
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 | 286 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | AVERA HEALTH PLANS, INC. | 214 | $1.2M |
| Dental(2 contracts) | DELTA DENTAL | 113 | $70K |
| Vision(3 contracts, 2 carriers) | AVERA HEALTH PLANS, INC. | 214 | $943K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 194 | $30K |
| Prescription drug(2 contracts) | AVERA HEALTH PLANS, INC. | 214 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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."
No prospect flags tripped on this filing.