| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $3K | $16K | 8.23% |
| HAYS COMPANIES, INC.3 | 201 SOUTH MAIN STREET, SUITE 2100 SALT LAKE CITY, UT 84111 | HARTFORD LIFE AND ACCIDENT | $18K | $0 | $18K | 12.91% |
| MJ INSURANCE3 Filed as: ELITE ADMIN. AND VARIOUS AGENTS | 313 HARKINS BLUFF DRIVE GREET, SC 29651 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 3.35% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES | 1830 BRENT BOULEVARD LINCOLN, NE 68506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $187 | $3K | 2.70% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E. ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $245 | $2K | 1.71% |
| THOMAS B. HOUSE3 | 2145 MAPLE STREET SIDNEY, NE 69162 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.63% |
| THOMAS W BOSTON3 Filed as: THOMAS D. FULLER | 1830 BRENT BOULEVARD LINCOLN, NE 68506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.54% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $230 | $1K | 1.29% |
| JERRY A EDGAR3 Filed as: JERRY A. EDGAR | 604 SOUTH MARKET STREET SHICKLEY, NE 68436 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $745 | $16 | $761 | 0.66% |
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 | 236 | 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) | 236 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $189K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $189K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 240 | $139K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 240 | $139K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 240 | $139K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 240 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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.