| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KINGSTON LIFE & HEALTH3 Filed as: KINGSTON LIFE AND HEALTH | 1755 WEST LAKES PKWY WEST DES MOINES, IA 50266 | DELTA DENTAL OF IOWA | $6K | — | $6K | 4.11% |
| NATIONAL CORPORATE BENEFITS GROUP3 | 1755 WEST LAKES PKWY HY-LINE BLDG STE C WEST DES MOINES, IA 50266 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 13.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF RD 5TH FL ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 14.55% |
| KINGSTON LIFE & HEALTH3 Filed as: KINGSTON LIFE AND HEALTH | 1755 WEST LAKES PKWY WEST DES MOINES, IA 50266 | VERATRUS BENEFIT SOLUTIONS | $2K | — | $2K | 9.15% |
| NATIONAL CORPORATE BENEFITS GROUP3 | 1755 WEST LAKES PARKWAY SUITE C WEST DES MOINES, IA 50266 | TLIC | $7K | — | $7K | 51.66% |
| CALVIN J KOHLENBERG3 | PO BOX 1513 DUBUQUE, IA 520041513 | TLIC | $952 | — | $952 | 6.85% |
| NATIONAL CORPORATE BENEFITS GROUP3 | 1755 WEST LAKES PKWY SUITE C WEST DES MOINES, IA 50266 | HARTFORD FIRE INSURANCE COMPANY | $187 | — | $187 | 14.96% |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 127 | $1.4M |
| Dental | DELTA DENTAL OF IOWA | 135 | $148K |
| Vision | VERATRUS BENEFIT SOLUTIONS | 127 | $19K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 171 | $78K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 171 | $78K |
| Prescription drug | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 127 | $1.4M |
| Other(5 contracts, 5 carriers) | WELLMARK BLUE CROSS BLUE SHIELD OF IOWA | 171 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.