| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST INSURANCE GROUP LLC3 | PO BOX 45279 OMAHA, NE 681450279 | BLUE CROSS BLUE SHIELD OF NEBRASKA | $49K | — | $49K | 1.29% |
| FIRST INSURANCE GROUP LLC3 | 14010 FNB PKWY STE 300 OMAHA, NE 68154 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 4.44% |
| FIRST INSURANCE GROUP LLC3 | PO BOX 45279 OMAHA, NE 68145 | AMERITAS LIFE INSURANCE CORP | $6K | $825 | $7K | 11.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS TOWERS WATSON 3RD PARTY SERVICES | Contract Administrator Service code 13 | 8400 NORMANDALE LAKE BOULEVARD SUITE 1700 MINNEAPOLIS, MN 554373837 | $27K |
| CASTLIGHT 3RD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 150 SPEAR STREET SUITE 400 SAN FRANCISCO, CA 94105 | $27K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 3RD PARTY ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $21K |
| DIA-TEC CLOUD 3RD PARTY SERVICES | Contract Administrator Service code 13 | 2910 S 84TH ST. OMAHA, NE 68124 | $16K |
| SIMPLYWELL, INC. 3RD PARTY SERVICES | Contract Administrator Service code 13 | P.O. BOX 122483 DALLAS, TX 753122483 | $11K |
| OPTUM FINANCIAL SERVICES 3RD PARTY SERVICE PROVIDE | Claims processing; Contract Administrator Service code 12 | 11000 OPTUM CIRCLE EDEN PRAIRE, MN 55344 | $10K |
| JELLYVISION LAB 3RD PARTY SERVICES | Contract Administrator Service code 13 | 848 W EASTMAN ST. SUITE 104 CHICAGO, IL 60642 | $9K |
| COMPSYCH CORPORATION EIN 36-3739783 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 455 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 355 | $3.8M |
| Vision | AMERITAS LIFE INSURANCE CORP | 609 | $63K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 385 | $145K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 385 | $145K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 385 | $145K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NEBRASKA | 355 | $3.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 385 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.