| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNION AGENCY, INC.3 | P.O. BOX 6205 LINCOLN, NE 68506 | ASSURITY LIFE INSURANCE COMPANY | $50K | — | $50K | 18.00% |
| UNION AGENCY, INC.3 | P.O. BOX 6205 LINCOLN, NE 68506 | AMERITAS LIFE INSURANCE COMPANY | $3K | $298 | $3K | 4.25% |
| UNION AGENCY, INC.3 Filed as: UNION AGENCY | P.O. BOX 6205 LINCOLN, NE 68506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.00% |
| NICHOLAS F. KELLEY3 | 17110 MARCY ST STE 104 OMAHA, NE 68118 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $681 | $2K | 7.55% |
| RICHARD DONADO3 | 10250 REGENCY CTR OMAHA, NE 68114 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | — | $754 | $754 | 2.83% |
| CORBIN L. LAMBERT3 | 14301 FNB PARKWAY STE 100 OMAHA, NE 68514 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $74 | $0 | $74 | 0.28% |
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 | 702 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 702 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE COMPANY | 946 | $81K |
| Life insurance | ASSURITY LIFE INSURANCE COMPANY | 702 | $278K |
| Long-term disability(2 contracts, 2 carriers) | ASSURITY LIFE INSURANCE COMPANY | 702 | $305K |
| Other(2 contracts, 2 carriers) | ASSURITY LIFE INSURANCE COMPANY | 702 | $337K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 946 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.