| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANNIE JOHNSON3 Filed as: DANNIE CHRIS JOHNSON | PO BOX 336243 GREELEY, CO 80633 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21K | — | $21K | 10.18% |
| VARIOUS3 | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $712 | $229 | $941 | 0.46% |
| STEVEN R. JOBMAN, INC3 | P.O. BOX 518 BRIDGEPORT, NE 69336 | PRUDENTIAL FINANCIAL | $16K | — | $16K | 18.31% |
| ACRISURE LLC7 Filed as: ACRISURE, LLC DBA BENEFIT HEALTH AD | 9605 KINGSTON CT, SUITE 150 ENGLEWOOD, CO 80112 | HCC LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| STEVEN R. JOBMAN, INC3 | P.O. BOX 518 BRIDGEPORT, NE 693360518 | VISION SERVICE PLAN | $752 | — | $752 | 7.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGIONAL CARE INC EIN 47-0760050 TPA | Claims processing Service code 12 | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | $65K |
| S & S HEALTHCARE STRATEGIES LTD EIN 31-1418743 PPO NETWORK | Insurance services Service code 23 | PO BOX 645704 CINCINNATI, OH 45264 | $50K |
| STEVE R JOBMAN EIN 47-0770869 BROKER | Insurance agents and brokers Service code 22 | P O BOX 518 BRIDGEPORT, NE 69336 | $33K |
| ACRISURE LLC - BENEFIT HEALTH ADVIS EIN 26-3554645 CONSULTING GENERAL | Consulting (general) Service code 16 | PO BOX 1788 GRAND RAPIDS, MI 49501 | $5K |
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 | 254 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 258 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 255 | $10K |
| Long-term disability | PRUDENTIAL FINANCIAL | 34 | $14K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 114 | $689K |
| Other(9 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 379 | $374K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 379 | — |
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.