| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE TEXAS RISK ADVISORS & INS | 5057 KELLER SPRINGS ROAD, SUITE 200 ADDISON, TX 75001 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 12.22% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET, SUITE 200 ELKHORN, NE 68022 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $640 | $2K | 6.97% |
| ACRISURE LLC3 Filed as: ACRISURE TEXAS RISK ADV & INS SVCS | 2150 SOUTH CENTRAL EXPRESSWAY SUITE 280 MCKINNEY, TX 75070 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $634 | $3K | 11.01% |
| ELLERBROCK-NORRIS AGENCY, INC.3 | 2203 OSBORNE DRIVE WEST HASTINGS, NE 68901 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $634 | $2K | 6.39% |
| BRIAN M. LEITZEL AND OTHER AGENTS3 | 4201 SPRING DRIVE CHENEY, KS 67025 | AFLAC | $843 | $0 | $843 | 3.36% |
| CAMILLE L OHRI3 Filed as: CAMILLE L. OHRI | 6108 T AVENUE KEARNEY, NE 68847 | AFLAC | $834 | — | $834 | 3.33% |
| MARJORIE A ZISKA3 Filed as: MARJORIE A. ZISKA | 524 EAST DONEGAL STREET O NEILL, NE 68763 | AFLAC | $156 | $0 | $156 | 0.62% |
| LINDA C MOORE LEGGETTE3 Filed as: LINDA C. MOORE LEGGETTE | 302 NORTH COLLEGE STREET ULYSSES, KS 67880 | AFLAC | $154 | $0 | $154 | 0.61% |
| CHARLES L PRICE3 Filed as: CHARLES L. PRICE | 915 EAST DONEGAL STREET O NEILL, NE 68763 | AFLAC | $112 | $0 | $112 | 0.45% |
| JAMES A BELLOWS3 Filed as: JAMES A. BELLOWS | 205 SOUTH LINCOLN AVENUE, SUITE 203 NEW YORK, NE 68467 | AFLAC | $90 | $0 | $90 | 0.36% |
| TONI L HARMS3 Filed as: TONI L. HARMS | 5925 EAST STATE HIGHWAY 41 ADAMS, NE 68301 | AFLAC | $85 | $0 | $85 | 0.34% |
| REGIONAL CARE INC3 Filed as: REGIONAL CARE, INC. | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | TOKIO MARINE HCC -A&H GROUP | $2K | $0 | $2K | 10.00% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $28K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 167 | $34K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 101 | $28K |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 167 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.