| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 11.17% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA P.O. BOX 415840 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.82% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA P.O. BOX 415840 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.89% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA P.O. BOX 415840 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | AMERITAS LIFE INSURANCE CORPORATION | $2K | — | $2K | 7.18% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | AMERITAS LIFE INSURANCE CORPORATION | $794 | — | $794 | 2.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 50 BRAINTREE HILL OFFICE PARK SUITE 310 BRAINTREE, MA 02184 | AMERITAS LIFE INSURANCE CORPORATION | — | $491 | $491 | 1.74% |
| DOUGLAS GEORGE KEELER3 | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | ASSURITY LIFE INSURANCE | $6K | — | $6K | 28.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | ASSURITY LIFE INSURANCE | $4K | — | $4K | 15.69% |
| ANTHONY C BUECHLER3 Filed as: ANTHONY CURTIS BUECHLER | 1203 COLONIAL CIRCLE OMAHA, NE 68046 | ASSURITY LIFE INSURANCE | $2K | — | $2K | 8.48% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | ASSURITY LIFE INSURANCE | $10 | — | $10 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $680 | — | $680 | 11.25% |
| LOCKTON COMPANIES, LLC3 | C/O BANK OF AMERICA P.O. BOX 415840 BOSTON, MA 02241 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $227 | — | $227 | 3.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD NEBRASKA EIN 47-0095156 MEDICAL & DENTAL ADMIN. | Contract Administrator; Claims processing Service code 12 | — | $175K |
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 | 207 | 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) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 152 | $28K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $43K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8 | $6K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.