| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 93033 NETWORK PLACE CHICAGO, IL 60673 | AMERICAN ALTERNATIVE INSURANCE CORPORATION | $30K | — | $30K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 18.36% |
| THOMAS JAMES BUTLER3 | 7913 N 164TH ST BENNINGTON, NE 68007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $610 | $69 | $679 | 8.54% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $202 | $46 | $248 | 3.12% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $144 | $63 | $207 | 2.60% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $141 | $51 | $192 | 2.42% |
| STERLING WEALTH MANAGEMENT LLC3 | C/O CHARLES JAEGER BROOKFIELD, WI 53045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $95 | $29 | $124 | 1.56% |
| CRISS BUTLER3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $17 | $59 | 0.74% |
| JULIA C SHARP3 | 5810 NORTH 166TH ST OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
| DIANE L STOIBER3 Filed as: DIANE AHDEA JARVIS | 19155 HI VIEW DR BROOKFIELD, WI 53045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.03% |
| MIDLANDS FINANCIAL BENEFITS3 | 7101 S 82ND ST LINCOLN, NE 68516 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $235 | — | $235 | 6.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $111 | — | $111 | 4.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 4.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $427K |
| BLUE CROSS AND BLUE SHIELD OF NE EIN 47-0095156 NONE | Plan Administrator Service code 14 | — | $70K |
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 NONE | Plan Administrator Service code 14 | — | $20K |
| WELLS FARGO BANK EIN 94-1347393 NONE | Account maintenance fees Service code 65 | — | $9K |
| WILLIS OF WISCONSIN INC EIN 39-0765647 BROKER | Other commissions Service code 55 | — | $0 |
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 | 944 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 953 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN ALTERNATIVE INSURANCE CORPORATION | 718 | $197K |
| Short-term disability(4 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 10 | $15K |
| Stop-loss / reinsurancereinsurance | AMERICAN ALTERNATIVE INSURANCE CORPORATION | 718 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 718 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.