| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| N/A | — | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | $31K | — | $31K | 2.29% |
| GROUP BENEFIT PARTNERS LLC3 | 914 AVENUE G FORT MADISON, IA 52627 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $18K | $6K | $24K | 22.56% |
| RYAN BERVEN | 4200 UNIVERSITY AVE SUITE 200 WEST DES MOINES, IA 50266 | TRANSAMERICA LIFE INSURANCE COMPANY | $3K | — | $3K | 16.27% |
| CALVIN J KOHLENBERG Filed as: CALVIN KOHLENBERG | PO BOX 1513 DUBUQUE, IA 52004 | TRANSAMERICA LIFE INSURANCE COMPANY | $459 | — | $459 | 2.80% |
| NATIONAL CORPORATEBENEFITS GROUP | 1755 WEST LAKES PARKWAY WEST DES MOINES, IA 50266 | TRANSAMERICA LIFE INSURANCE COMPANY | $108 | — | $108 | 0.66% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLANS LLC DBA | 914 AVENUE G FORT MADISON, IA 52627 | TRANSAMERICA LIFE INSURANCE COMPANY | $57 | — | $57 | 0.35% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS DBA GROUP BENEFIT P | 914 AVENUE G FORT MADISON, IA 52627 | VERATRUS BENEFIT SOLUTIONS | $952 | — | $952 | 10.00% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS LLC | 914 AVENUE G FORT MADISON, IA 52627 | HARTFORD FIRE INSURANCE COMPANY | $149 | — | $149 | 15.05% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS DBA GROUP BENEFIT P | 914 AVENUE G FORT MADISON, IA 52627 | DELTA DENTAL OF IOWA | $4K | — | $4K | — |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS GREAT PLAINS LLC | 4200 UNIVERSITY AVE SUITE 200 WEST DES MOINES, IA 50266 | DELTA DENTAL OF IOWA | — | $157 | $157 | — |
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 | 132 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF IOWA | 99 | $1.4M |
| Dental | DELTA DENTAL OF IOWA | 105 | $0 |
| Vision | VERATRUS BENEFIT SOLUTIONS | 89 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $107K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $107K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $107K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.