| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 8.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 15.00% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 8.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $638 | $638 | 1.25% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 22.31% |
| SUPPLEMENTAL INSURANCE PROFESSIONAL3 Filed as: SUPPLEMENTAL INS PROF LLC | 1956 PARK AVENUE DES MOINES, IA 50315 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 3.80% |
| ALAN PAPE3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $46 | — | $46 | 0.09% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 7.62% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $466 | $466 | 1.25% |
| TIM OLSON INC3 | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 19.55% |
| SUPPLEMENTAL INSURANCE PROFESSIONAL3 Filed as: SUPPLEMENTAL INS PROF LLC | 1956 PARK AVENUE DES MOINES, IA 50315 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.38% |
| PAPE ALAN3 | 115 EAST PLATT STREET MAQUOKETA, IA 52060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $804 | — | $804 | 2.84% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $354 | $354 | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $320 | $320 | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $286 | $286 | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $479 | — | $479 | 2.62% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $210 | $210 | 1.15% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.00% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $183 | $183 | 1.25% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $371 | — | $371 | 2.85% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $163 | $163 | 1.25% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP INCORPORATED | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $434 | $95 | $529 | 4.45% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $443 | — | $443 | 3.72% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $69 | $69 | 0.58% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $650 | — | $650 | 7.57% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $102 | $102 | 1.19% |
| OLSON, TIMOTHY H3 | 16820 FRANCES STREET SUITE 101 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $670 | — | $670 | 9.57% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH DBA TIM OLSON INC | 16820 FRANCES STREET SUITE 202 OMAHA, NE 68130 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $105 | $105 | 1.50% |
| TIM OLSON INC3 Filed as: TIM OLSON INC. | — | SCRIPTSOURCING, LLC | $28K | — | $28K | — |
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 | 490 | 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) | 490 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $37K |
| Long-term disability(11 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $551K |
| Prescription drug | SCRIPTSOURCING, LLC | 24 | $0 |
| Stop-loss / reinsurancereinsurance | IRONSHORE INDEMNITY, INC. | 460 | $538K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 490 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.