| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS LLC - MTN REGION | 800 NORMAN CENTER DR. SUITE 400 BLOOMINGTON, MN 55437 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $25K | $0 | $25K | 7.33% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | FOUNDERS SERIES 444 W 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $6K | $0 | $6K | 1.85% |
| MARCOTTE INSURANCE AGENCY INC3 Filed as: MARCOTTE INSURANCE AGENCY | 9394 W DODGE RD, SUITE 250 OMAHA, NE 68114 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $36 | $0 | $36 | 0.01% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 E UNION AVE STE 700 DENVER, CO 802372966 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 9.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BCH, VA 234662817 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $1K | $3K | 4.27% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 KANSAS CITY, MO 641121906 | AMERITAS LIFE INSURANCE CORP. | $5K | $521 | $5K | 9.01% |
| USI INSURANCE SERVICES LLC3 | 9394 W DODGE RD STE 250 OMAHA, NE 681143319 | AMERITAS LIFE INSURANCE CORP. | $1K | $1K | $2K | 3.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $872 | $4K | 22.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | PO BOX 843844 KANSAS CITY, MO 641843844 | EYEMED VISION CARE | $668 | — | $668 | 6.72% |
| USI INSURANCE SERVICES LLC3 | 9394 W DODGE ROAD SUITE 250 OMAHA, NE 68114 | EYEMED VISION CARE | $475 | — | $475 | 4.78% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | 86 | $346K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 97 | $61K |
| Vision(2 contracts, 2 carriers) | AMERITAS LIFE INSURANCE CORP. | 183 | $71K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $70K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $70K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $70K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 115 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.