| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $0 | $12K | 20.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED | $623 | $0 | $623 | 9.06% |
| USI INSURANCE SERVICES LLC3 | 9700 ORMSBY STATION ROAD, SUITE 200 LOUISVILLE, KY 40242 | TRANSAMERICA LIFE INSURANCE COMPANY | $308 | $0 | $308 | 5.37% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $228 | $0 | $228 | 3.98% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $121 | $0 | $121 | 2.11% |
| DANE PAPE3 Filed as: DANE PAPAE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $114 | $0 | $114 | 1.99% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $342 | $0 | $342 | 6.24% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $286 | $0 | $286 | 5.22% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $124 | $0 | $124 | 2.26% |
| DANE PAPE3 Filed as: DANE PAPAE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $123 | $0 | $123 | 2.24% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.20% |
| CHERYL A. COBBIN4 | 2931 TILDEN DRIVE ROSEVILLE, CA 95661 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $703 | $0 | $703 | 29.06% |
| WARREN G BENDER CO4 Filed as: WARREN G. BENDER COMPANY | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $128 | $0 | $128 | 5.29% |
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 | 265 | 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) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED | 135 | $7K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 265 | $65K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 265 | $59K |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 265 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.