| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REGIONAL CARE INC3 Filed as: REGIONAL CARE, INC. | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | AIG BENEFIT SOLUTIONS | $6K | — | $6K | 10.00% |
| STEVEN R. JOBMAN, INC3 | P.O. BOX 518 BRIDGEPORT, NE 69336 | PRUDENTIAL FINANCIAL | $10K | — | $10K | 16.15% |
| STEVEN R. JOBMAN, INC3 | P.O. BOX 518 BRIDGEPORT, NE 69336 | VISION SERVICE PLAN | $762 | — | $762 | 7.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGIONAL CARE, INC. EIN 47-0760050 TPA | Claims processing Service code 12 | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | $92K |
| STEVE R. JOBMAN EIN 47-0770869 BROKER | Insurance agents and brokers Service code 22 | P.O. BOX 518 BRIDGEPORT, NE 69336 | $19K |
| INGMIRE PHILLIPS INSURANCE INC EIN 84-0723707 BROKER | Insurance agents and brokers Service code 22 | 216 CLAYTON STREET BRUSH, CO 80723 | $10K |
| COFINITY EIN 20-1274723 PPO | Insurance services Service code 23 | 5231 PAYSHPERE CIRCLE CHICAGO, IL 606745231 | $8K |
| MIDLANDS CHOICE EIN 47-0804331 PPO NETWORK | Insurance services Service code 23 | 8420 W. DODGE ROAD, SUITE 210 OMAHA, NE 68114 | $8K |
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 | 260 | 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) | 260 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 253 | $10K |
| Life insurance(2 contracts) | PRUDENTIAL FINANCIAL | 377 | $87K |
| Long-term disability(2 contracts) | PRUDENTIAL FINANCIAL | 177 | $71K |
| Stop-loss / reinsurancereinsurance | AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS | 262 | $347K |
| Other(10 contracts, 2 carriers) | AIG BENEFIT SOLUTIONS | 377 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.