| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC4 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | BLUE CROSS BLUE SHIELD | — | $114 | $114 | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD EIN 47-0095156 NONE | Contract Administrator Service code 13 | 7261 MERCY ROAD OMAHA, NE 68180 | $555K |
| WELLNESS PARTNERS LLC EIN 20-5668686 NONE | Other services Service code 49 | PO BOX 488 MCCOOK, NE 69001 | $262K |
| UNITED HEALTH CARE EIN 41-1289245 NONE | Contract Administrator Service code 13 | 9700 HEALTH CARE LANE MINNETONKA, MN 55343 | $157K |
| AMERITAS EIN 47-0098400 NONE | Contract Administrator Service code 13 | PO BOX 81889 LINCOLN, NE 68501 | $40K |
| PAYFLEX EIN 47-0804495 NONE | Contract Administrator Service code 13 | 10802 FARNAM DR SUITE 100 OMAHA, NE 68154 | $14K |
| WELLS FARGO EIN 94-1347393 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 1248 O ST LINCOLN, NE 68508 | $11K |
| PRIME THERAPEUTICS | Other fees Service code 99 | PO BOX 650041 DALLAS, TX 75265 | $0 |
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 | 968 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 969 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 979 | $379K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 979 | $379K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD | 979 | $379K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 979 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.