| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OCI INSURANCE & FINANCIAL SERVICES3 Filed as: OCI INS. AND FIN. SERVICES, INC. | 4221 NORTH 203RD STREET, SUITE 200 ELKHORN, NE 68022 | UNITEDHEALTHCARE INSURANCE COMPANY | $34K | $0 | $34K | 7.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE OMAHA, NE 68114 | UNITEDHEALTHCARE INSURANCE COMPANY | -$60 | — | -$60 | -0.01% |
| BUTZE INSURANCE INC.3 | 1511 448TH UTICA, NE 68456 | AFLAC | $3K | $104 | $3K | 4.33% |
| STARR BUCKOW INSURANCE AGENCY3 | PO BOX 515 FAIRBURY, NE 68352 | AFLAC | $2K | $0 | $2K | 3.15% |
| CHELSEA M. SCHERNIKAU3 | 503 SOUTH Z ROAD HENDERSON, ME 68371 | AFLAC | $2K | $21 | $2K | 2.91% |
| JAMES A BELLOWS3 Filed as: JAMES A. BELLOW | PO BOX 549 YORK, NE 68467 | AFLAC | $775 | $8 | $783 | 1.09% |
| HEATHER D. HOLLAND3 | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $441 | $2 | $443 | 0.62% |
| MITCHELL M ALLNER3 Filed as: MITCHELL M. ALLNER AND OTHER AGENTS | 8600 EXECUTIVE WOODS DRIVE LINCOLN, NE 68512 | AFLAC | $354 | $6 | $360 | 0.50% |
| TODD H BURRER3 Filed as: TODD H. BURRER | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $354 | $0 | $354 | 0.49% |
| MJ INSURANCE3 Filed as: KEVIN S. KARES AND VARIOUS AGENTS | 208 TURKEY CREEK WAY HENDERSON, NV 89074 | AFLAC | $231 | $0 | $231 | 0.32% |
| OCI INSURANCE & FINANCIAL SERVICES3 Filed as: OCI INS. AND FIN. SERVICES, INC. | 4221 NORTH 203RD STREET, SUITE 200 ELKHORN, NE 68022 | AMERITAS LIFE INSURANCE CORPORATION | $3K | $295 | $4K | 6.80% |
| OCI INSURANCE & FINANCIAL SERVICES3 Filed as: OCI INS. AND FIN. SERVICES, INC. | 4221 NORTH 203RD STREET, SUITE 200 ELKHORN, NE 68022 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 14.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10050 REGENCY CIRCLE OMAHA, NE 68114 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $1 | $70 | 4.74% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E. ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $61 | $4 | $65 | 4.40% |
| MA STILES LLC3 | 12223 CUMING STREET OMAHA, NE 68154 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 1.83% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $1 | $10 | 0.68% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.54% |
| DEAN W FORNOFF3 Filed as: DEAN W. FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.27% |
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 | 134 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 166 | $462K |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 167 | $52K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 167 | $52K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $26K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 166 | $462K |
| Other(4 contracts, 4 carriers) | AFLAC | 147 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.