| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | 800 MAIN STREET DUBUQUE, IA 52001 | BLUE CROSS OF CALIFORNIA | $63K | $172 | $63K | 3.87% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W. HILLSDALE BLVD., SUITE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $31K | $31K | 1.91% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | 800 MAIN STREET DUBUQUE, IA 52001 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $166 | $2K | 8.77% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SVCS. | 800 MAIN STREET DUBUQUE, IA 52001 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $421 | $1 | $422 | 3.87% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $209 | $209 | 1.92% |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 330 | $1.6M |
| Vision(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 333 | $28K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 333 | $11K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 330 | $1.6M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 333 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 333 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.