| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $14K | $14K | 4.67% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $6K | $6K | 1.91% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $5K | $5K | 4.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 2.68% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $304 | $206 | $510 | 3.35% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | NATIONAL UNION FIRE INS. CO. | — | $2K | $2K | 15.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | NATIONAL UNION FIRE INS. CO. | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF NEBRASKA EIN 47-0095156 MEDICAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $526K |
| DELTA DENTAL OF NEBRASKA EIN 47-0685003 DENTAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $42K |
| WEX FSA ADMINISTRATOR | Contract Administrator Service code 13 | 700 26TH AVENUE E WEST FARGO, ND 58078 | $30K |
| MATRIX ABSENCE MANAGEMENT, INC. EIN 77-0493584 STD ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $28K |
| CURALINC, LLC EIN 33-1206383 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $18K |
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 | 919 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 933 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 5 | $97K |
| Dental | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 5 | $97K |
| Vision | VISION SERVICE PLAN | 955 | $106K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 919 | $403K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 919 | $200K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 851 | $617K |
| Other(5 contracts, 5 carriers) | ARMADACARE | 1,122 | $897K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,122 | — |
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."
No prospect flags tripped on this filing.