| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 111 E KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.77% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 111 E KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.08% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 111 E KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.17% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 10.00% |
| DOUGLAS GEORGE KEELER3 | 2209 1ST AVENUE PLATTSMOUTH, NE 68048 | ASSURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.87% |
| ANTHONY C BUECHLER3 Filed as: ANTHONY CURTIS BUECHLER | 1203 COLONIAL CIRCLE OMAHA, NE 68046 | ASSURITY LIFE INSURANCE COMPANY | $980 | — | $980 | 5.17% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ASSURITY LIFE INSURANCE COMPANY | $833 | — | $833 | 4.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE, SUITE 300 OMAHA, NE 68114 | ASSURITY LIFE INSURANCE COMPANY | $372 | — | $372 | 1.96% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| LOCKTON COMPANIES, LLC3 | 111 E KILBOURN AVENUE, SUITE 825 MILWAUKEE, WI 53202 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $411 | $411 | 3.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEBRASKA EIN 47-0095156 MEDICAL & DENTAL ADMIN. | Contract Administrator; Claims processing Service code 12 | — | $213K |
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 | 416 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 418 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP. | 144 | $26K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 11 | $12K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.