| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARCOTTE INSURANCE AGENCY INC3 | 9394 W DODGE RD STE 250 OMAHA, NE 68114 | BLUE CROSS BLUE SHIELD NEBRASKA | $58K | — | $58K | 16.98% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $12K | $24K | 22.45% |
| NFP INSURANCE SERVICES INC3 | 1250 S CAPITAL OF TEXAS HWY W LAKE HILLS, TX 78746 | PRINCIPAL LIFE INSURANCE COMPANY | — | $6K | $6K | 5.51% |
| MARCOTTE INSURANCE AGENCY INC3 | 9394 W DODGE RD STE 250 OMAHA, NE 68114 | PRINCIPAL LIFE INSURANCE COMPANY | $956 | — | $956 | 0.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WEX HEALTH, INC. EIN 45-0283315 PROCESS CLAIMS, RECORDS | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | PO BOX 2764 FARGO, ND 58108 | $3K |
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 | 94 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD NEBRASKA | 0 | $341K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $105K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $105K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $105K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $105K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $105K |
| Prescription drug | BLUE CROSS BLUE SHIELD NEBRASKA | 0 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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.