| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLMARK INC0 Filed as: WELLMARK OF SOUTH DAKOTA, INC | 1331 GRAND AVE DES MOINES, IA 50309 | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, INC. | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 511064647 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $0 | $16K | 11.30% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 328013277 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 511064647 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $41 | $41 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $16 | $16 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD FL 11 ROLLING MDWS, IL 600084050 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 4200 CORPORATE DR., SUITE 160 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | $0 | $5K | 13.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4200 CORPORATE DR, SUITE 160 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $429 | $429 | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $345 | $345 | 0.91% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA, INC. | 145 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 312 | $98K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 312 | $98K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 323 | $139K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 323 | $139K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 323 | $139K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 323 | $177K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 323 | — |
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.