Iowa employer health plans: what they cost and who gets paid
Updated plan year 2024, the most recent complete year
619 Iowa employers filed health plans with 100 or more participants for plan year 2024, covering 446,584 participants. They reported $803M in insurance premiums and $42M in broker commissions and fees. The median broker rate on commission-paying, fully insured medical plans was 1.6% of premium, 2.2 points below the national median of 3.8%.
Largest brokers
Reported commissions and fees, with the number of employer plans naming each.
Largest medical carriers
Medical premium written.
Cities in Iowa
Every Iowa city where 15 or more employers filed a health plan, by the sponsor's mailing address. Each page lists the city's largest plans, brokers and carriers.
| City | Employer plans | Premiums |
|---|---|---|
| Des Moines | 79 | $278M |
| Cedar Rapids | 60 | $45M |
| West Des Moines | 38 | $61M |
| Davenport | 29 | $34M |
| Dubuque | 29 | $5.8M |
| Sioux City | 23 | $19M |
Largest employer plans
By health plan participants.
Highest broker pay
Employers reporting the most broker commissions and fees.
Highest commission rates
Fully insured medical plans with at least $500,000 in premium, ranked by broker compensation as a share of premium.
Source: DOL Form 5500 and Schedule A, plan year 2024; built October 24, 2026. Methodology.
What do Iowa employers pay health insurance brokers?
Across 55 fully insured medical plans in plan year 2024, among commission-paying fully insured medical plans, the median broker compensation for Iowa employers was 1.6% of premium (middle half 1.1% to 2.4%), against a national median of 3.8%. In dollars, the median employer that disclosed broker pay reported $38,968.
Which Iowa employers paid the most in broker commissions?
Hy-Vee, Inc. reported the most in 2024, $2,176,098, followed by Casey's General Stores, Inc ($1.7M) and LCS Community Employment LLC ($1.3M).
Which brokers and carriers dominate Iowa?
By reported compensation, the largest brokers are Holmes Murphy, Gallagher, Cottingham & Butler. By medical premium, the largest carriers are Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Health Plan of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota.
Which Iowa cities have the most employer health plans?
Des Moines (79 employer plans, $278M in premiums); Cedar Rapids (60 employer plans, $45M in premiums); West Des Moines (38 employer plans, $61M in premiums); Davenport (29 employer plans, $34M in premiums); Dubuque (29 employer plans, $5.8M in premiums). 6 Iowa cities with 15 or more employer plans have their own page listing the largest plans, brokers and carriers.
Is your company on this page? Get its Form 5500 read next to the Iowa medians.
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