| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES-SC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | DELTA DENTAL OF IOWA | $6K | $208 | $6K | 4.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $12K | $150 | $13K | 10.12% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRAIL SIOUX FALLS, IA 57108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 6.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 718 SIOUX CITY, IA 51102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $139 | $2K | 4.12% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $472 | $100 | $572 | 1.48% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $407 | $95 | $502 | 1.29% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $0 | $94 | 0.24% |
| JON SCOTT SWARTZENDRUBER3 | 1805 5TH AVE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $0 | $38 | 0.10% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES-SC | 2 PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | DELTAVISION | $3K | $2K | $5K | 19.71% |
| MJ INSURANCE3 Filed as: VARIOUS BROKERS | — | AFLAC | $513 | $0 | $513 | 9.65% |
| BROKER NOT PROVIDED3 | — | EFR EMPLOYEE & FAMILY RESOURCES | $260 | $0 | $260 | 5.01% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 49 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 336 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF IOWA | 136 | $130K |
| Vision | DELTAVISION | 133 | $25K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 207 | $124K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 207 | $124K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 207 | $124K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 281 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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.