| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $41K | — | $41K | 15.29% |
| NEBRASKA METHODIST HEALTH SYSTEM5 | 825 S 169 STREET OMAHA, NE 68118 | BESTCARE EAP | — | $10K | $10K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF NEBRASKA EIN 47-0685003 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $23K |
| GALLAGHER BENEFIT SERVICES EIN 36-4291971 AGENT | Insurance agents and brokers Service code 22 | SUITE 500 3600 AMERICAN BLVD BLOOMINGTON, MN 55431 | $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 | 256 | 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) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | BLUE LINK | 226 | $1.5M |
| Vision | VISION SERVICE PLAN | 385 | $53K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 257 | $268K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 257 | $268K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 257 | $268K |
| Stop-loss / reinsurancereinsurance(4 contracts, 2 carriers) | BLUE LINK | 226 | $1.5M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 313 | $268K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 385 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.