| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | SYMETRA LIFE INSURANCE COMPANY | — | $17K | $17K | 5.70% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 10.44% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ASSURITY LIFE INSURANCE COMPANY | $10K | — | $10K | 68.49% |
| AMY LORRAINE LUTHER3 Filed as: AMY LUTHER | 6620 NW DEARING DRIVE PARKVILLE, MO 64152 | AFLAC | $396 | — | $396 | 4.24% |
| INSPRO INC3 Filed as: INSPRO INC. | 100 E 6TH STREET FREMONT, NE 68025 | AFLAC | $147 | — | $147 | 1.57% |
| JAMES A BELLOWS3 | P.O. BOX 549 YORK, NE 68467 | AFLAC | $127 | — | $127 | 1.36% |
| MONICA BLAINE BROCKMAN3 Filed as: MONICA BROCKMAN | 2301 BURLINGTON STREET, SUITE 200 NORTH KANSAS CITY, MO 64116 | AFLAC | $61 | — | $61 | 0.65% |
| CHAD J BASLER3 Filed as: CHAD BASLER | 460 NE LAKES EDGE DRIVE LEES SUMMIT, MO 64064 | AFLAC | $59 | — | $59 | 0.63% |
| ROBERT C JOHNSTON3 | 817 S BRIDLE TRAIL LN PECULIAR, MO 64078 | AFLAC | $42 | — | $42 | 0.45% |
| ERIC J HENNEGIN3 | 7604 S PEOGA ROAD TRAFALGAR, IN 46181 | AFLAC | $36 | — | $36 | 0.39% |
| THE LUTHER GROUP LLC3 | 6620 NW DEARING DRIVE PARKVILLE, MO 64152 | AFLAC | $35 | — | $35 | 0.37% |
| THOMAS EDWARD SHEFFIELD3 Filed as: THOMAS EDWARD SHEFFILED | P.O. BOX 151 MC COOL JUNCTION, NE 68401 | AFLAC | $22 | — | $22 | 0.24% |
| KERRY R PICKARD3 | 8534 N OVERLAND DRIVE KANSAS CITY, MO 64154 | AFLAC | $20 | — | $20 | 0.21% |
| SANDRA KARL3 Filed as: SANDRA K KARL | 18400 SW 100TH STREET CRETE, NE 68333 | AFLAC | $19 | — | $19 | 0.20% |
| KRINGS ENTERPRISES INC3 Filed as: KRINGS ENTERPRISES INC. | 1330 PRAIRIE RIDGE DRIVE POLK CITY, IA 50226 | AFLAC | $15 | — | $15 | 0.16% |
| FRANCES POTTER3 | 1540 N COTNER BLVD, APT 215 LINCOLN, NE 68505 | AFLAC | $13 | — | $13 | 0.14% |
| TARA M HELLER3 Filed as: TARA HELLER | 455 S SAM BARR DRIVE, ,SUITE 205 KEARNEY, MO 64060 | AFLAC | $11 | — | $11 | 0.12% |
| JEREMY FRYE & ASSOCIATES INC3 | 1508 N CHURCH ROAD, SUITE B LIBERTY, MO 64068 | AFLAC | $10 | — | $10 | 0.11% |
| JANICE ROBINSON3 | 22010 BRIDGESTONE HAWK COURT SPRING, TX 77388 | AFLAC | $10 | — | $10 | 0.11% |
| KATRINA K MCMECHAN3 | 2244 COUNTRY CLUB ROAD GRENADA, MS 38901 | AFLAC | $9 | — | $9 | 0.10% |
| KRISTY GRAMLICH INC3 Filed as: KRISTY GRIMLICH INC. | 455 S SAM BARR DRIVE, SUITE 205 KEARNEY, MO 64060 | AFLAC | $9 | — | $9 | 0.10% |
| CYNTHIA K CARD3 | 5042 KNOX STREET LINCOLN, NE 68504 | AFLAC | $8 | — | $8 | 0.09% |
| MICHAEL COPPESS3 | 108 N 49TH STREET, SUITE 207 OMAHA, NE 68132 | AFLAC | $7 | — | $7 | 0.07% |
| KENNETH A OSTERMEIER3 | 215 COLETON DRIVE COPPERAS COVE, TX 76522 | AFLAC | $7 | — | $7 | 0.07% |
| BRANDON DRAEGER INC3 Filed as: BRANDON DRAEGER | 649 COUNTY ROAD 2500 CRETE, NE 68333 | AFLAC | $7 | — | $7 | 0.07% |
| TARA JORDAN3 | 800 LAKESHORE DRIVE TUSCOLA, IL 61953 | AFLAC | $6 | — | $6 | 0.06% |
| RYAN LAGER3 | 8342 N OVERLAND DRIVE KANSAS CITY, MO 64151 | AFLAC | $6 | — | $6 | 0.06% |
| DAWN SHERLOCK & ASSOCIATES INC3 Filed as: DAWN SHERLOCK & ASSOCIATES INC. | 7868 GERALD AVENUE LINCOLN, NE 68516 | AFLAC | $6 | — | $6 | 0.06% |
| BUTZKE INSURANCE INC3 | 1511 448TH UTICA, NE 68456 | AFLAC | $5 | — | $5 | 0.05% |
| KIMBERLY DIAN CROCKETT3 | 1563 ASHLEY CREEK LN CORDOVA, TN 38016 | AFLAC | $5 | — | $5 | 0.05% |
| BRENT L GOODE3 | 2000 GLEN ECHO ROAD, SUITE 204 NASHVILLE, TN 37215 | AFLAC | $5 | — | $5 | 0.05% |
| CYNTHIA D WELKEN-PLACE3 Filed as: CYNTHIA D. WELKEN-PLACE | 14710 W DODGE ROAD, SUITE 200 OMAHA, NE 68154 | AFLAC | $4 | — | $4 | 0.04% |
| GARY WILLINGHAM3 | 6033 STRAFFORD OAKS DRIVE SEBRING, FL 33875 | AFLAC | $4 | — | $4 | 0.04% |
| KEVIN B VINING3 | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC | $4 | — | $4 | 0.04% |
| TAMARA E RUSH3 | 9319 TAYLOR CLIFF LN CYPRESS, TX 77433 | AFLAC | $4 | — | $4 | 0.04% |
| ESTHER L BEZAN3 Filed as: ESTHER GOEDEN | 7911 NASHWAY ROAD LINCOLN, NE 68516 | AFLAC | $3 | — | $3 | 0.03% |
| RANDY W BRADSHAW3 | 4004 NE 62ND TERR GLADSTONE, MO 64119 | AFLAC | $3 | — | $3 | 0.03% |
| KENNETH R THOMASON3 | 4610 N 134TH AVENUE OMAHA, NE 68164 | AFLAC | $2 | — | $2 | 0.02% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $2 | — | $2 | 0.02% |
| MICHAEL L BRAUN3 | 1718 DEVOE DR LINCOLN, NE 68506 | AFLAC | $2 | — | $2 | 0.02% |
| JOSEPH ZEZZA3 | 448 RUSHFOIL DRIVE COLUMBIA, SC 29229 | AFLAC | $2 | — | $2 | 0.02% |
| MICHAEL OSTERMEIER3 Filed as: MICHAEL E OSTERMEIER | 1735 STERLING TRACE DR KELLER, TX 76248 | AFLAC | $1 | — | $1 | 0.01% |
| JENNIFER SMITH3 Filed as: JENNIFER L SMITH | 319 N MAIN AVENUE, SUITE 130 SPRINGFIELD, MO 65806 | AFLAC | $1 | — | $1 | 0.01% |
| CRAIG M REMMERS3 Filed as: CRAIG REMMERS | 23245 W LE BOST NOVI, MI 48375 | AFLAC | $1 | — | $1 | 0.01% |
| MICHAEL S CEJKA3 | 5901 BRANFORD PLACE LINCOLN, NE 68512 | AFLAC | $1 | — | $1 | 0.01% |
| DANIEL J MCMECHAN3 | 2244 COUNTRY CLUB ROAD GRENADA, MS 38901 | AFLAC | $1 | — | $1 | 0.01% |
| LUCAS MAGDANZ3 | 6931 BERNESE BLVD LINCOLN, NE 68516 | AFLAC | $1 | — | $1 | 0.01% |
| JOHN A DONALDSON3 | 25211 GROGANS MILL ROAD SUITE 305 THE WOODLANDS, TX 77380 | AFLAC | $1 | — | $1 | 0.01% |
| DONNA BAILEY3 | 902 S ANN DRIVE MARSHALL, MO 65340 | AFLAC | $1 | — | $1 | 0.01% |
| JOSEPH L LEDOUX3 | 2411 CARTER AVENUE NASHVILLE, TN 37206 | AFLAC | $1 | — | $1 | 0.01% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | EYEMED VISION CARE | $493 | — | $493 | 10.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEBRASKA EIN 47-0095156 ADMINISTRATOR | Contract Administrator Service code 13 | — | $137K |
| SIMPLYWELL ADMINISTRATOR | Contract Administrator Service code 13 | 9140 WEST DODGE RD, 408 402-552-3415 OMAHA, NE 68114 | $14K |
| AMERITAS LIFE INSURANCE CORP. EIN 47-0098400 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $12K |
| INFINISOURCE ADMINISTRATOR | Contract Administrator Service code 13 | 15 E. WASHINGTON STREET 800-300-3838 COLDWATER, MI 49036 | $7K |
| LOCKTON COMPANIES, LLC EIN 20-3354970 INSURANCE BROKER | Insurance brokerage commissions and fees Service code 53 | — | $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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 60 | $5K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $103K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $103K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $103K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 146 | $302K |
| Other(2 contracts, 2 carriers) | ASSURITY LIFE INSURANCE COMPANY | 65 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.