| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | HARVARD PILGRIM HEALTH CARE OF NE, INC. | $71K | — | $71K | 2.53% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | HARVARD PILGRIM HEALTH CARE OF NE, INC. | $35K | — | $35K | 1.26% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | HPHC INSURANCE COMPANY | $8K | — | $8K | 3.88% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | HPHC INSURANCE COMPANY | $4K | — | $4K | 1.93% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 9.05% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.17% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 9.10% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.17% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 12.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 6.11% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCTON COMPANIES LLC | 777 FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $913 | $3K | 11.96% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.25% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 777 S FIGUEROA ST STE 5200 LOS ANGELES, CA 90017 | EYEMED VISION CARE | $1K | — | $1K | 6.64% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL RD STE 100 ROCHESTER, NY 14625 | EYEMED VISION CARE | $624 | — | $624 | 3.36% |
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 | 266 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HARVARD PILGRIM HEALTH CARE OF NE, INC. | 315 | $3.0M |
| Vision | EYEMED VISION CARE | 292 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 266 | $101K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 266 | $71K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 266 | $28K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 266 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.