| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP, INC. | 11516 MIRACLE HILLS DRIVE, STE 100 OMAHA, NE 68154 | SANFORD HEALTH PLAN | $18K | — | $18K | 0.82% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR. OMAHA, SD 68154 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 6.63% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE, STE 100 OMAHA, NE 68154 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | 11516 MIRACLE HILLS DRIVE, STE 100 OMAHA, NE 68154 | EYE MED | $1K | — | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR. OMAHA, NE 68154 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 16.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR. OMAHA, NE 68154 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 16.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DR. OMAHA, NE 68154 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $303 | — | $303 | 14.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | 1300 W 57TH ST STE 101 SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $941 | — | $941 | — |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SANFORD HEALTH PLAN | 349 | $2.2M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 370 | $0 |
| Vision | EYE MED | 380 | $13K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 255 | $40K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 209 | $21K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 255 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.