| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 | PO BOX 441 DES MOINES, IA 50302 | HARTFORD LIFE AND ACCIDENT | $77K | $7K | $84K | 16.33% |
| AVANT SPECIALTY BENEFITS LLC3 | 2727 GRAND PRAIRIE PKWY WAUKEE, IA 50263 | HARTFORD LIFE AND ACCIDENT | $10K | — | $10K | 2.04% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14K | $2K | $16K | 4.17% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES INC | PO BOX 441 DES MOINES, IA 50302 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | — | $10K | 2.61% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $482 | $4K | 1.12% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $53 | $3K | 0.74% |
| JERRY A EDGAR3 | 604 SOUTH MARKET ST SHICKLEY, NE 68436 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $36 | $2K | 0.56% |
| INFINIUM ENTERPRISES LLC3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 0.45% |
| KIMBERLY LEWIS3 | 13911 JOSEPHINE ST OMAHA, NE 68138 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.34% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $606 | — | $606 | 0.16% |
| THOMAS W BOSTON3 Filed as: THOMAS D FULLER | 1830 BRENT BLVD LINCOLN, NE 68506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $368 | — | $368 | 0.09% |
| EDGILL ENTERPRISES LLC3 | 1420 WEST Q ST LINCOLN, NE 68506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $166 | $38 | $204 | 0.05% |
| MA STILES LLC3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.00% |
| R C SCHOPP & ASSOCIATES INC3 | PO BOX 350 BOYS TOWN, NE 68010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES INC | 13810 FNB PARKWAY OMAHA, NE 68154 | AMERITAS LIFE INSURANCE CORP | $3K | $1K | $5K | 3.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF SC EIN 57-0287419 CONTRACT ADM/CLAIMS PROC | Contract Administrator; Claims processing Service code 12 | PO BOX 100121 COLUMBIA, SC 292023121 | $539K |
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 | 687 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 708 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP | 1,335 | $116K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 779 | $513K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 779 | $513K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 779 | $513K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 779 | $903K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,335 | — |
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.