| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIM JARDINE3 | HOLMES MURPHY PO BOX 9207 DES MOINES, IA 50306 | AVERA HEALTH PLANS, INC. | $37K | — | $37K | 1.54% |
| LORI LEWISON3 | MUTUAL MED INSURANCE SERVICES LLC 4321 EAST 60TH STREET DAVENPORT, IA 52807 | AVERA HEALTH PLANS, INC. | $7K | — | $7K | 0.30% |
| TIM JARDINE3 | HOLMES MURPHY AND ASSOCIATES 5120 SOUTH SOLBERG AVENUE SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $2K | — | $2K | 1.21% |
| LORI LEWISON3 | WORKPLACE MARKETING 4301 WEST 57TH STREET #126 SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $445 | — | $445 | 0.28% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | PO BOX 441 DES MOINES, IA 50302 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 7.52% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES INC | PO BOX 441 DES MOINES, IA 50302 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $559 | $6 | $565 | 5.16% |
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 | 339 | 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) | 339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AVERA HEALTH PLANS, INC. | 491 | $2.4M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 241 | $156K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $99K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $99K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $99K |
| Prescription drug | AVERA HEALTH PLANS, INC. | 491 | $2.4M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 339 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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."
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.