| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFITS LD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | PRINCIPAL LIFE INSURANCE COMPANY | $77K | $25K | $102K | 17.24% |
| ACRISURE LLC3 | PO BOX 2897 EVANS, GA 30809 | PRINCIPAL LIFE INSURANCE COMPANY | — | $12K | $12K | 2.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15K | $0 | $15K | 6.42% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $1K | $11K | 4.83% |
| DALE I DAVIS3 Filed as: DALE JOHNSTON | 1612 M AVE MILFORD, IA 51351 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $153 | $4K | 1.73% |
| RICHARD G MCGOWAN3 | 1716 N 59TH ST OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $69 | $2K | 0.90% |
| KIMBERLY LEWIS3 | 13911 JOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $64 | $2K | 0.77% |
| NIKOLE R WULFF3 | PO BOX 3193 OMAHA, NE 68103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.76% |
| FIRST AMERICAN INSURANCE3 | 2621 W US HWY 30 GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.69% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $167 | $1K | 0.57% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.46% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $533 | $334 | $867 | 0.38% |
| JERRY A EDGAR3 | 7021 S 38TH ST LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $0 | $127 | 0.05% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $97 | $0 | $97 | 0.04% |
| BRYON A BROWDER3 | 75 NW 57TH PL DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $0 | $92 | 0.04% |
| DEAN W FORNOFF3 | 16041 BUFFALO RD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.01% |
| CRISS BUTLER3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.01% |
| MA STILES LLC3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.01% |
| JENNIFER L HAVLOVICK3 | 4920 PLEASANT ST WEST DES MOINES, IA 50266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.00% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
| JOAN C MCGILL3 | 1721 N 127ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| TODD BURKE3 Filed as: TODD MICHAEL COHOE | 2835 S 1036TH ST OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $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 | 585 | 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) | 585 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 422 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,384 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.