| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | BLUE CROSS BLUE SHIELD OF NEBRASKA | $63K | $4K | $67K | 4.19% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | AMERITAS LIFE INSURANCE CORP | $3K | $1K | $4K | 6.64% |
| DUANE A ADAMS3 Filed as: DUANE L GOTTSCH | 2220 NORTH 172ND AVENUE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 10.16% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $546 | $135 | $681 | 1.75% |
| MARTIN J URBANSKI3 | 2809 STATE ST GRAND ISLAND, NE 68803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $182 | $149 | $331 | 0.85% |
| JEFFERY ALLEN SCHILOUSKY3 | 621 TIBBALS ST HOLDREGE, NE 68949 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | $94 | $207 | 0.53% |
| TMB ENTERPRISES INC3 | 1307 EAST 31ST KEARNEY, NE 68847 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $21 | $51 | 0.13% |
| DALE PHILLIPS3 Filed as: DALE R PHILLIPS | RURAL ROUTE 2 PRINCETON, MO 64673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $2 | $10 | 0.03% |
| ELAINE MURPHY3 | 78507 LINKS DRIVE PALM DESERT, CA 92211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| COTTINGHAM & BUTLER3 | 800 MAIN ST DUBUQUE, IA 52001 | KANSAS CITY LIFE INSURANCE COMPANY | $674 | — | $674 | 11.92% |
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 | 105 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 119 | $1.6M |
| Dental | AMERITAS LIFE INSURANCE CORP | 259 | $65K |
| Vision | AMERITAS LIFE INSURANCE CORP | 259 | $65K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 118 | $6K |
| Other | KANSAS CITY LIFE INSURANCE COMPANY | 118 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.