| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOON CHAPMAN BENEFIT ADMINISTRATORS1 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | $12K | $55K | 19.23% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.15% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN | 250 PEHLE AVE STE 400 PARK 80 PLAZA SADDLE BROOK, NJ 076635826 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 6279 TRI RIDGE BLVD STE 400 LOVELAND, OH 45140 | METROPOLITAN LIFE INSURANCE COMPANY | — | $46 | $46 | 0.02% |
| V AND S MARKETING3 | 3188 DOGWOOD AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $5K | $11K | 12.79% |
| SDADA SERVICES INC3 | PO BOX 89008 SIOUX FALLS, SD 57109 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 3.23% |
| TMB ENTERPRISES INC3 | 18890 56TH ROAD KEARNEY, NE 68845 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $467 | $2K | 2.16% |
| RITA A FOUBERT3 | 204 MALLARD POINTE DR NW BONDURANT, IA 50035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $528 | $49 | $577 | 0.69% |
| GRUND BENEFIT ADVISORS LLC3 | 14669 MEREDITH AVE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $491 | — | $491 | 0.59% |
| JANIS ANN CLINEBELL3 | 2017 25 RD KEARNEY, NE 68847 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $418 | — | $418 | 0.50% |
| JAMES L MURPHY3 | 3016 S AMANDA COURT SIOUX FALLS, SD 57103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $292 | — | $292 | 0.35% |
| EMMALEE ANNE WESTFALL3 Filed as: EMMALEE ANNE WESTFALLS | 11107 LARAMIE ST. PAPILLION, NE 68046 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.13% |
| BROOMFIELD LLC3 | PO BOX 74 MCCOOK, NE 69001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $24 | $50 | 0.06% |
| KEVIN MURPHY3 Filed as: KEVIN ARMSTRONG INSURANCE INC | 4027 WEST FAIDLEY GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $19 | $49 | 0.06% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.05% |
| MARTIN J URBANSKI3 | 2809 STATE ST GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| JODI LYNN VANBEEK3 | 1502 12TH AVE ROCK VALLEY, IA 51247 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| GINA M WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| WILLIAM JAMES MURPHY3 | 3016 AMANDA CT SIOUX FALLS, SD 57106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 172 | $1.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $286K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $286K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $286K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $370K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $286K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 391 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 391 | — |
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.