| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ZACH CORPORATION3 Filed as: ZACH CORPORATION DBA GROUP BEN | 622 PROGRESS AVE PO BOX 2597 WATERLOO, IA 50701 | WELLMARK HEALTH PLAN OF IOWA, INC. | $15K | — | $15K | 0.62% |
| PEDERSEN DOWIE CLABBY3 | 3022 AIRPORT BLVD PO BOX 2597 WATERLOO, IA 50703 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | — | $20K | 6.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDONE, LC EIN 26-1769761 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1590 UNIVERSITY AVE DUBUQUE, IA 52001 | $27K |
| WELLMARK HEALTH PLAN OF IOWA, INC. EIN 42-1455449 CLAIMS PROCESSOR/ADMIN | Contract Administrator; Claims processing Service code 12 | 1331 GRAND AVE DES MOINES, IA 50309 | $15K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 | Contract Administrator; Claims processing Service code 12 | — | $14K |
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 | 510 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK HEALTH PLAN OF IOWA, INC. | 282 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $321K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $321K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $321K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $321K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $321K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 661 | — |
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.