| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $80K | $74K | $154K | 3.66% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $996 | $6K | 11.89% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $672 | $4K | 11.76% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $495 | $3K | 11.90% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $281 | $69 | $350 | 11.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 81889 LINCOLN, NE 68501 | $61K |
| PATRIOT GROWTH INSURANCE SVCS LLC EIN 83-1204744 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | $0 |
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 | 441 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 441 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | 682 | $4.2M |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 234 | $56K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 116 | $38K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 96 | $26K |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 234 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 682 | — |
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.