| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 10050 REGENCY CIR STE 300 OMAHA, NE 681143721 | DEARBORN LIFE INSURANCE COMPANY | $9K | — | $9K | 10.76% |
| WESLEY K JOHNSON II3 Filed as: WESLEY A SIEBERT | 1111 NORTH 102ND COURT STE 300 OMAHA, NE 68114 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | — | DELTA DENTAL OF NEBRASKA | $3K | — | $3K | 5.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SVCS INC | 4200 CORPORATE DR STE 160 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 18.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $135 | $135 | 0.40% |
| NEBRASKA METHODIST HEALTH SYSTEM5 | — | NEBRASKA METHODIST HEALTH SYSTEM D/B/A BESTCARE EAP | — | $5K | $5K | — |
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 | 131 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NEBRASKA | 190 | $59K |
| Vision | VISION SERVICE PLAN | 136 | $19K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 135 | $85K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 135 | $85K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 135 | $85K |
| Other(3 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 163 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.