| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | PO BOX 28 DUBUQUE, IA 52004 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $4K | $19K | 7.54% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET, STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $1K | $9K | 3.80% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICES | PO BOX 28 DUBUQUE, IA 52004 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $19 | $19 | 0.01% |
| GROVE, MARC, A3 Filed as: GROVE, MARC A | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $0 | $11K | 4.72% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 2.14% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $4K | 1.72% |
| GROVE, MARC, A3 Filed as: GROVE, MARC A | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.45% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $477 | $2K | 4.27% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $761 | $304 | $1K | 2.73% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM INSURANCE COMPANY | $778 | $156 | $934 | 3.76% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM INSURANCE COMPANY | $1K | $1K | $2K | 9.41% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM INSURANCE COMPANY | $9 | $9 | $18 | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | -$1 | -$1 | -0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 95287 CHICAGO, IL 60694 | UNUM INSURANCE COMPANY | -$8 | $0 | -$8 | -0.04% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTTLER | 800 MAIN ST DUBUQUE, IA 52001 | UNUM INSURANCE COMPANY | $645 | $378 | $1K | 5.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWQS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $115 | $115 | 0.67% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $551 | $2K | 10.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $447 | $89 | $536 | 3.16% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $86 | $86 | 0.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $86 | $86 | 0.98% |
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 | 713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 713 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 713 | $249K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 713 | $249K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 449 | $230K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 449 | $230K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 449 | $230K |
| Other(7 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 449 | $359K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 713 | — |
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.