| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER Filed as: COTTINGHAM & BROKER | 800 MAIN STREET DUBUQUE, IA 52001 | FAIR AMERICAN | $40K | — | $40K | 10.05% |
| FREDERICK STERLING BOLYARD3 Filed as: FREDERICK STERLYING BOLYARD | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $4K | $1K | $5K | 6.13% |
| CHRISTINE E MILLER3 | STE 160 2322 BLUE STONE HILLS DR HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $430 | $154 | $584 | 0.67% |
| VAN DER HYDE ASSOC INC3 | STE 300 3901 WESTERRE PKWY RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $430 | $52 | $482 | 0.55% |
| COTTINGHAM & BUTLER Filed as: COTTINGHAM & BROKER | 800 MAIN STREET DUBUQUE, IA 52001 | AMERITAS | $5K | $334 | $5K | 8.54% |
| FREDERICK STERLING BOLYARD3 | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $3K | $827 | $4K | 8.66% |
| CHRISTINE E MILLER3 | STE 160 2322 BLUE STONE HILLS DR HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $331 | $118 | $449 | 0.94% |
| VAN DER HYDE ASSOC INC3 | STE 300 3901 WESTERRE PKWY RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $331 | $40 | $371 | 0.78% |
| FREDERICK STERLING BOLYARD3 | 3959 ELECTRIC RD STE 460 ROANOKE, VA 24018 | NORTHWESTERN MUTUAL | $3K | $834 | $4K | 17.79% |
| CHRISTINE E MILLER3 | STE 160 2322 BLUE STONE HILLS DR HARRISONBURG, VA 22801 | NORTHWESTERN MUTUAL | $334 | $120 | $454 | 1.93% |
| VAN DER HYDE ASSOC INC3 | STE 300 3901 WESTERRE PKWY RICHMOND, VA 23233 | NORTHWESTERN MUTUAL | $334 | $40 | $374 | 1.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COTTINGHAM & BUTLER BROKER | Other services; Insurance brokerage commissions and fees Service code 49 | 800 MAIN ST DUBUQUE, IA 52001 | $47K |
| SISCO EIN 42-1144827 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 800 MAIN STREET DUBUQUE, IA 52004 | $29K |
| CIGNA EIN 06-1059331 PROVIDER NETWORK | Insurance services Service code 23 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $27K |
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 | 198 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS | 429 | $62K |
| Vision | AMERITAS | 429 | $62K |
| Life insurance | NORTHWESTERN MUTUAL | 220 | $48K |
| Short-term disability | NORTHWESTERN MUTUAL | 219 | $88K |
| Long-term disability | NORTHWESTERN MUTUAL | 58 | $23K |
| Stop-loss / reinsurancereinsurance | FAIR AMERICAN | 139 | $401K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.