| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KIMBERLY BECK3 | 800 MAIN ST DUBUQUE, IA 52004 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $60K | — | $60K | 1.96% |
| PROFESSIONAL INS ENROLLERS LLC3 | 54369 30TH ST SOUTH BEND, IN 46635 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $77K | — | $77K | 10.00% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE | SERVICES, INC. PO BOX 28 DUBUQUE, IA 520040028 | RELIASTAR LIFE INSURANCE COMPANY | $11K | — | $11K | 11.72% |
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 | 1,426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 461 | $3.0M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $773K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $773K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $773K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,277 | $868K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,277 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.