| 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. | $60K | $0 | $60K | 2.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 718 SIOUX CITY, IA 511020718 | AMERITAS LIFE INSURANCE CORP. | $17K | $0 | $17K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD FL 21 ROLLING MDWS, IL 600084050 | AMERITAS LIFE INSURANCE CORP. | $0 | $3K | $3K | 1.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4280 SERGEANT RD STE 200 SIOUX CITY, IA 511064647 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $107 | $13K | 12.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606907219 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $10 | $10 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 4280 SERGEANT ROAD, SUITE 200 SIOUX CITY, IA 51106 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7K | $0 | $7K | 13.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 4280 SERGEANT ROAD, SUITE 200 SIOUX CITY, IA 51106 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 6.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 4201 WESTOWN PKWY, SUITE 120 WEST DES MOINES, IA 502666720 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $898 | $0 | $898 | 1.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 4201 WESTOWN PKWY, SUITE 120 WEST DES MOINES, IA 502666720 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $258 | $0 | $258 | 0.50% |
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 | 290 | 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) | 290 | 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. | 202 | $2.2M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 470 | $166K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 470 | $166K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 443 | $209K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 443 | $111K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 443 | $209K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 443 | $261K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 470 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.