| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | PO BOX 28 DUBUQUE, IA 52004 | BLUE CROSS AND BLUE SHIELD OF TEXAS | $7K | $300 | $8K | 2.91% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET, 11TH FLOOR CHICAGO, IL 60654 | BLUE CROSS AND BLUE SHIELD OF TEXAS | $2K | $0 | $2K | 0.77% |
| BCI INSURANCE SOLUTIONS, INC.3 | UNKNOWN LAFAYETTE, LA 70503 | BLUE CROSS AND BLUE SHIELD OF TEXAS | $2K | $0 | $2K | 0.65% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET, 11TH FLOOR CHICAGO, IL 60654 | METROPOLITAN LIFE INSURANCE COMPANY | $422 | $109 | $531 | 13.27% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | PO BOX 28 DUBUQUE, IA 52004 | METROPOLITAN LIFE INSURANCE COMPANY | $2 | $23 | $25 | 0.62% |
| ALLIANT INSURANCE SERVICES, INC.3 | 5444 WESTHEIMER ROAD, SUITE 900 HOUSTON, TX 77056 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1 | $1 | 0.02% |
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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF TEXAS | 31 | $260K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $4K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $4K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $4K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF TEXAS | 31 | $260K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.