| 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.-SCULL CONSTRUCTION | $15K | — | $15K | 2.48% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURERS | 816 5TH STREET RAPID CITY, SD 57701 | AVERA HEALTH PLANS, INC.-SCULL CONSTRUCTION | $2K | — | $2K | 0.36% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURORS, INC. | 816 5TH STREET RAPID CITY, SD 57701 | SANFORD HEALTH PLAN - SCULL CONSTRUCTION INC | $10K | — | $10K | 3.05% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INC | 4321 E 60TH ST DAVENPORT, IA 52807 | AVERA HEALTH PLANS, INC -SITE WORK SPECIALISTS | $5K | — | $5K | 2.00% |
| WESTERN DAKOTA INSURORS3 | 816 5TH ST RAPID CITY, SD 57701 | AVERA HEALTH PLANS, INC -SITE WORK SPECIALISTS | $4K | — | $4K | 1.37% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 57701 | DELTA DENTAL-SCULL CONSTRUCTION | $1K | — | $1K | 2.52% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURORS INC | PO BOX 1300 RAPID CITY, SD 577091300 | PRINCIPAL LIFE INSURANCE COMPANY - SCULL CONSTRUCTION | $3K | — | $3K | 14.89% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INS SVCS LLC | 4321 E 60TH ST DAVENPORT, IA 528073505 | PRINCIPAL LIFE INSURANCE COMPANY - SCULL CONSTRUCTION | $583 | — | $583 | 3.25% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 57701 | DELTA DENTAL-SITE WORK SPECIALISTS | $815 | — | $815 | 4.62% |
| WESTERN DAKOTA INSURORS3 | 816 5TH ST RAPID CITY, SD 577013708 | VISION SERVICE PLAN - SCULL CONSTRUCTION | $705 | — | $705 | 7.75% |
| WESTERN DAKOTA INSURORS3 Filed as: WESTERN DAKOTA INSURORS INC | PO BOX 1300 RAPID CITY, SD 577091300 | PRINCIPLE LIFE INSURANCE -SITE WORK SPECIALISTS | $1K | — | $1K | 14.86% |
| MUTUAL MED INSURANCE SERVICES3 Filed as: MUTUAL MED INSURANCE SERVICES, LLC | 4321 E 60TH ST. DAVENPORT, IA 528073505 | PRINCIPLE LIFE INSURANCE -SITE WORK SPECIALISTS | $315 | — | $315 | 4.31% |
| WESTERN DAKOTA INSURORS3 | 816 5TH STREET RAPID CITY, SD 577013708 | VISION SERVICE PLAN - SITE WORK SPECIALISTS | $317 | — | $317 | 10.03% |
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 | 139 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AVERA HEALTH PLANS, INC.-SCULL CONSTRUCTION | 211 | $1.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL-SCULL CONSTRUCTION | 125 | $70K |
| Vision(3 contracts, 3 carriers) | AVERA HEALTH PLANS, INC.-SCULL CONSTRUCTION | 203 | $616K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY - SCULL CONSTRUCTION | 177 | $25K |
| Prescription drug(2 contracts, 2 carriers) | AVERA HEALTH PLANS, INC.-SCULL CONSTRUCTION | 203 | $877K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 211 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.