| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LORI LEWISON3 | WORKPLACE MARKETING 4301 WEST 57TH ST #126 SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $2K | — | $2K | 1.56% |
| LORI LEWISON3 | 4301 W 57TH ST STE 126 SIOUX FALLS, SD 571082258 | VISION SERVICE PLAN | $2K | — | $2K | 3.83% |
| MUTUAL MED INSURANCE SERVICES3 | 4321 E 60TH STREET DAVENPORT, IA 52807 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| LORI D LEWISON3 Filed as: LORI D. LEWISON | 4301 W 57TH STREET SIOUX FALLS, SD 57108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.84% |
| MUTUAL MED INSURANCE SERVICES3 | 4321 E 60TH STREET DAVENPORT, IA 52807 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 10.00% |
| MUTUAL MED INSURANCE SERVICES3 | 4321 E 60TH STREET DAVENPORT, IA 52807 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $776 | — | $776 | 15.00% |
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 | 222 | 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) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK OF SOUTH DAKOTA INC | 222 | $1.6M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 358 | $140K |
| Vision | VISION SERVICE PLAN | 175 | $42K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 278 | $37K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 87 | $29K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 87 | $34K |
| Prescription drug | WELLMARK OF SOUTH DAKOTA INC | 222 | $1.6M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 278 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.