| 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 | AMERITAS LIFE INSURANCE CORPORATION | $4K | $805 | $4K | 7.47% |
| BUTZKE INSURANCE INC3 Filed as: BUTZKE INSURANCE INC. | 1511 448TH UTICA, NE 68456 | AFLAC | $4K | $76 | $4K | 8.55% |
| STARR BUCKOW INSURANCE AGENCY3 | PO BOX 515 FAIRBURY, NE 68352 | AFLAC | $3K | $15 | $3K | 5.78% |
| CHELSEA M. SCHERNIKAU3 | 503 SOUTH Z ROAD HENDERSON, NE 68371 | AFLAC | $2K | $0 | $2K | 4.02% |
| MITHELL M. ALLNER3 | 701 WEST 101ST PLACE SOUTH APARTMENT 1801 JENKS, OK 74037 | AFLAC | $526 | $8 | $534 | 1.17% |
| MJ INSURANCE3 Filed as: TODD H. BURRER AND VARIOUS AGENTS | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $433 | $7 | $440 | 0.96% |
| JAMES A BELLOWS3 Filed as: JAMES A. BELLOWS | 205 SOUTH LINCOLN AVENUE, SUITE 203 YORK, NE 68467 | AFLAC | $327 | $0 | $327 | 0.72% |
| HEATHER D. HOLLAND3 | 621 OAKMOUNT DRIVE PLATTSMOUTH, NE 68048 | AFLAC | $183 | $0 | $183 | 0.40% |
| 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 | $1K | $5K | 19.35% |
| BUTZKE INSURANCE INC3 Filed as: BUTZKE INSURANCE INC. | 1511 448TH UTICA, NE 68456 | AFLAC | $768 | $23 | $791 | 3.14% |
| CHELSEA M. SCHERNIKAU3 | 503 SOUTH Z ROAD HENDERSON, NE 68371 | AFLAC | $667 | $5 | $672 | 2.67% |
| STARR BUCKOW INSURANCE AGENCY3 | PO BOX 515 FAIRBURY, NE 68352 | AFLAC | $614 | $0 | $614 | 2.44% |
| JAMES A BELLOWS3 Filed as: JAMES A. BELLOWS | 205 SOUTH LINCOLN AVENUE, SUITE 203 YORK, NE 68467 | AFLAC | $308 | $0 | $308 | 1.22% |
| HEATHER D. HOLLAND3 | 621 OAKMOUNT DRIVE PLATTSMOUTH, NE 68048 | AFLAC | $180 | $0 | $180 | 0.72% |
| TODD H BURRER3 Filed as: TODD H. BURRER | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $142 | $0 | $142 | 0.56% |
| ROSS C NELSON3 Filed as: ROSS C. NELSON | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $99 | $5 | $104 | 0.41% |
| 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 | 2.80% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E. ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 2.80% |
| MA STILES LLC3 | 12223 CUMING STREET OMAHA, NE 68154 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.96% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRLCE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.79% |
| DEAN W FORNOFF3 Filed as: DEAN W. FORNOFF | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.35% |
| OCI INSURANCE & FINANCIAL SERVICES3 Filed as: OCI INS. AND FIN. SERVICES, INC. | 4221 NORTH 203RD STREET, SUITE 200 ELKHORN, NE 68022 | UNITEDHEALTHCARE INSURANCE COMPANY | $37K | — | $37K | — |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 133 | $0 |
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 272 | $60K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 272 | $60K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 186 | $27K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 133 | $0 |
| Other(5 contracts, 4 carriers) | AFLAC | 186 | $101K |
| 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."
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.