| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP, LLC | 14010 FNB PARKWAY SUITE 300 OMAHA, NE 68154 | UNITEDHEALTHCARE INSURANCE COMPANY | $29K | $0 | $29K | 1.53% |
| UNICO GROUP INC3 Filed as: UNICO GROUP, INC. | 1128 LINCOLN MALL SUITE 200 LINCOLN, NE 68508 | UNITEDHEALTHCARE INSURANCE COMPANY | $27K | $0 | $27K | 1.44% |
| KERRY RAE BUTZKE3 Filed as: KERRY BUTZKE | 1511 448TH UTICA, NE 68456 | AFLAC | $7K | $390 | $7K | 8.63% |
| STARR BUCKOW INSURANCE AGENCY3 Filed as: STARR BUCKOW INS AGENCY | PO BOX 515 FAIRBURY, NE 68352 | AFLAC | $4K | $0 | $4K | 5.29% |
| GABBY MASON AND OTHER AGENTS3 | 2125 FOLKWAYS BOULEVARD LINCOLN, NE 68521 | AFLAC | $1K | $181 | $1K | 1.82% |
| RIHA BENEFITS GROUP INC3 Filed as: RIHA BENEFITS GROUP, INC. | 302 EAST 6TH STREET STUART, NE 68780 | AFLAC | $1K | $123 | $1K | 1.61% |
| CHELSEA M. SCHERNIKAU3 Filed as: CHELSEA SCHERINKAU | 503 SOUTH ZONE ROAD HENDERSON, NE 68371 | AFLAC | $1K | $0 | $1K | 1.23% |
| HUNTER HARTSHORN3 | 12370 V ROAD GRESHAM, NE 68367 | AFLAC | $700 | $0 | $700 | 0.86% |
| JAMES A BELLOWS3 Filed as: JAMES BELLOWS | 205 SOUTH LINCOLN AVENUE SUITE 203 YORK, NE 68467 | AFLAC | $443 | $0 | $443 | 0.55% |
| UNICO GROUP INC3 Filed as: UNICO GROUP, INC. | 1128 LINCOLN MALL, SUITE 200 LINCOLN, NE 68508 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 11.99% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP, LLC | 14010 FNB PARKWAY SUITE 300 OMAHA, NE 68154 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 7.28% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET SUITE 200 ELKHORN, NE 68022 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
| KERRY RAE BUTZKE3 Filed as: KERRY THOMAS | 141 SOUTH 6TH STREET APARTMENT 1 UTICA, NE 68456 | AFLAC | $5K | $211 | $5K | 18.80% |
| HUNTER HARTSHORN3 | 12370 V ROAD GRESHAM, NE 68367 | AFLAC | $1K | $0 | $1K | 4.68% |
| CHELSEY RIHA3 | 302 EAST 6TH STREET STUART, NE 68780 | AFLAC | $494 | $15 | $509 | 2.02% |
| JOHN C MACKIE3 Filed as: JOHN MACKIE | 8408 LAVERN ROAD PLEASANT VALLEY, MO 64068 | AFLAC | $77 | $0 | $77 | 0.31% |
| THOMAS J PITZENBERGER3 Filed as: THOMAS PITZENBERGER AND OTHERS | 1501 SUGARLAND PARKWAY PLEASANT HILL, MO 64080 | AFLAC | $39 | $20 | $59 | 0.23% |
| TIMOTHY ASBY3 | 11500 GOLDEN WILLOW COURT ZIONSVILLE, IN 46077 | AFLAC | $23 | $0 | $23 | 0.09% |
| AUSTIN J PETERSON3 Filed as: AUSTIN PETERSON | 11116 AURORA AVENUE URBANDALE, IA 50322 | AFLAC | $16 | $0 | $16 | 0.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $0 | $41 | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 10050 REGENCY CIRCLE OMAHA, NE 68114 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 1.96% |
| HOVIE AGENCY LLC3 Filed as: HOVIE AGENCY, LLC | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.74% |
| MA STILES LLC3 Filed as: MA STILES, LLC | 12223 CUMING STREET OMAHA, NE 68154 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.67% |
| FIRST INSURANCE GROUP LLC3 Filed as: FIRST INSURANCE GROUP, LLC | UNKNOWN ALLIANCE, NE 69301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.55% |
| MAMIE A STILES3 | 12223 CUMING STREET OMAHA, NE 68154 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.37% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.25% |
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 | 272 | 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) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.9M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.9M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.9M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 203 | $40K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 272 | $1.9M |
| Other(5 contracts, 4 carriers) | AFLAC | 228 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.