| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INSURANCE SER | 800 MAIN STREET DUBUQUE, IA 52001 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $26K | — | $26K | 2.42% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $2K | — | $2K | 0.20% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SVCS INC | 800 MAIN ST DUBUQUE, IA 52001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $212 | $9K | 12.82% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BUILDING DUBUQUE, IA 52001 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 7.62% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BUILDING DUBUQUE, IA 52001 | WYSSTA INSURANCE COMPANY INC | $743 | — | $743 | 8.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $93 | — | $93 | 5.47% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $69 | $2 | $71 | 4.18% |
| GETTYSBURG BENEFITS ADMINISTRATORS3 Filed as: GETTYSBURG BENEFITS ADMINISTRATORS, | INC. DBA BENAW GETTYSBURG BENEFITS 777 BALTIMORE ST STE 97 GETTYSBURG, PA 17325 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28 | — | $28 | 1.65% |
| GEBO, MICKEY, JOHN3 | 480 LOUD ROAD FAIRPORT, NY 14450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.35% |
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 | 108 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 170 | $1.4M |
| Dental | DELTA DENTAL OF WISCONSIN | 57 | $63K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 170 | $1.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $69K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $69K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.