| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $649 | $5K | 22.87% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 12.07% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 402 WICHITA, KS 67202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 11.82% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $888 | — | $888 | 7.20% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $888 | — | $888 | 7.20% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $81 | — | $81 | 0.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $262 | $2K | 22.93% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $818 | — | $818 | 10.99% |
| USI INSURANCE SERVICES LLC3 | 9700 ORMSBY STATION ROAD, SUITE 200 LOUISVILLE, KY 40242 | TRANSAMERICA LIFE INSURANCE COMPANY | $776 | — | $776 | 14.93% |
| RHONDA S PAPE3 Filed as: RHONDA S. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $593 | — | $593 | 11.41% |
| COLE PAPE3 Filed as: COLE M. PAPE | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $294 | — | $294 | 5.66% |
| DANE PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | TRANSAMERICA LIFE INSURANCE COMPANY | $277 | — | $277 | 5.33% |
| B & C AGENCY INC4 | 7867 SE 197TH TERRACE LATHAM, KS 67072 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $353 | — | $353 | 16.34% |
| USI INSURANCE SERVICES LLC4 | 245 NORTH WACO STREET, SUITE 402 WICHITA, KS 67202 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $105 | — | $105 | 4.86% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF AMERICA | $262 | $38 | $300 | 22.92% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 139 | $7K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 109 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 109 | $23K |
| Other(4 contracts, 4 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 265 | $19K |
| 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.