| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INC | 11516 MIRACLE HILLS DR SUITE 100 OMAHA, NE 681544473 | UNITED OF OMAHA LIFE INSURANCE CO (1) | — | $14K | $14K | 6.05% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INC | 11516 MIRACLE HILLS DRIVE OMAHA, NE 68154 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 4.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | AMERICAN HERITAGE LIFE | $24K | — | $24K | 15.38% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INC | 11516 MIRACLE HILLS DR SUITE 100 OMAHA, NE 681544473 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $504K |
| OPTUM BANK EIN 47-0858534 NONE | Account maintenance fees Service code 65 | — | $19K |
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 | 1,049 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE | 248 | $156K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 894 | $47K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO (1) | 1,010 | $270K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 665 | $159K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 729 | $671K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,010 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,010 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.