| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LTD3 | 4151 EXECUTIVE PKWY WESTERVILLE, OH 43081 | PRINCIPAL LIFE INSURANCE COMPANY | $52K | $8K | $60K | 10.60% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.25% |
| QCC INSURANCE COMPANY5 | 1901 MARKET ST PHILADELPHIA, PA 19103 | QCC INSURANCE COMPANY | $0 | $186K | $186K | 42.39% |
| DAN SHUTT-GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | QCC INSURANCE COMPANY | $30K | $0 | $30K | 6.82% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $9K | $0 | $9K | 4.76% |
| ROBERT ELLIS3 | 11261 WRIGHT CIR OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $7K | $773 | $7K | 3.75% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $3K | $1K | $4K | 1.98% |
| JASON DENNIS HOSEK3 Filed as: JASON D HOSEK | 700 WILD PINE CT SPRINGVILLE, IA 52336 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $2K | $0 | $2K | 0.82% |
| KIMBERLY LEWIS3 | 13911 JOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1K | $28 | $1K | 0.73% |
| JERRY A EDGAR3 | PO BOX 383 SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1K | $31 | $1K | 0.64% |
| FIRST AMERICAN INSURANCE3 | 2621 W US HWY 30 GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1K | $0 | $1K | 0.51% |
| RICHARD G MCGOWAN3 | 1716 N 59TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $567 | $2 | $569 | 0.29% |
| MICHAEL DONLEY3 | 6300 S MAPLE ROCK TRL SIOUX FALLS, SD 57108 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $203 | $0 | $203 | 0.10% |
| BARBARA MARIE MCDONALD3 | 1630 TIMBER CT SE CEDAR RAPIDS, IA 52403 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $129 | $0 | $129 | 0.07% |
| DUSTIN LEE CLAIR3 | 4814 M AVE NW CEDAR RAPIDS, IA 52405 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $129 | $0 | $129 | 0.07% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $39 | $0 | $39 | 0.02% |
| EDGHILL ENTERPRISES LLC3 | 2701 N 70TH ST APT D87 LINCOLN, NE 68507 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $31 | $1 | $32 | 0.02% |
| MA STILES LLC3 | 12223 CUMMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $6 | $0 | $6 | 0.00% |
| JOEL KEITH STRADINGER3 Filed as: JOEL K STRADINGER | 2514 N 69TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $6 | $0 | $6 | 0.00% |
| DEAN W FORNOFF3 Filed as: DEAN FORNOFF | 16041 BUFFALO RD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $4 | $0 | $4 | 0.00% |
| TODD COHOE3 | 2835 S 1036TH ST OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE CO. | $1 | $0 | $1 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 1,332 | 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) | 1,332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QCC INSURANCE COMPANY | 428 | $440K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,332 | $565K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,332 | $565K |
| Stop-loss / reinsurancereinsurance | QCC INSURANCE COMPANY | 428 | $440K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE CO. | 278 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,332 | — |
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.