| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $14K | $14K | 5.29% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $9K | $9K | 5.27% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 5.29% |
| J2T2 ENTERPRISES INC3 | 10135 SO 162ND ST OMAHA, NE 68136 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 8.20% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 5.17% |
| ECKERT BENEFITS GROUP INC3 | 625 MORRISON DR OMAHA, NE 68154 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.49% |
| ROSS C NELSON3 Filed as: ROSS NELSON | 2771 LEIGH LANE PAPILLION, NE 68133 | CONTINENTAL AMERICAN INSURANCE COMPANY | $898 | — | $898 | 1.30% |
| MARK FRIEHE3 | 4611 S 96TH ST STE 101 OMAHA, NE 68127 | CONTINENTAL AMERICAN INSURANCE COMPANY | $634 | — | $634 | 0.92% |
| EJ ENTERPRISES3 | 10135 SO 162ND ST OMAHA, NE 68136 | CONTINENTAL AMERICAN INSURANCE COMPANY | $495 | — | $495 | 0.72% |
| TODD H BURRER3 | 17445 ARBOR STREET SUITE 300 OMAHA, NE 68130 | CONTINENTAL AMERICAN INSURANCE COMPANY | $363 | — | $363 | 0.53% |
| STEVEN R YENNEY3 Filed as: STEVEN R YENNY | 18412 HOWARD ST ELKHORN, NE 68022 | CONTINENTAL AMERICAN INSURANCE COMPANY | $270 | — | $270 | 0.39% |
| THOMAS E SHEFFIELD3 | PO BOX 151 MCCOOL JUNCTION, NE 68401 | CONTINENTAL AMERICAN INSURANCE COMPANY | $237 | — | $237 | 0.34% |
| GREG A LITZ3 | 2005 GATEWAY DR GRAND FORKS, ND 58203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $232 | — | $232 | 0.34% |
| KACHATURIAN ENTERPRISES INC3 | 530 S 161ST CIRCLE OMAHA, NE 68116 | CONTINENTAL AMERICAN INSURANCE COMPANY | $90 | — | $90 | 0.13% |
| KIMBERLY DIAN CROCKETT3 Filed as: KIMBERLY D CROCKETT | 1563 ASHLEY CREEK LN CORDOVA, TN 38016 | CONTINENTAL AMERICAN INSURANCE COMPANY | $74 | — | $74 | 0.11% |
| MICHAEL COPPESS3 | 4910 DODGE ST STE 107 OMAHA, NE 68132 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.09% |
| CYNTHIA D WELKEN-PLACE3 Filed as: CYNTHIA WELKEN-PLACE | 601 CODY DR BISMARK, ND 58503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 0.07% |
| KENNETH R THOMASON3 Filed as: KENNETH THOMASON | 14710 WEST DODGE ROAD STE 200 OMAHA, NE 68154 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.03% |
| CATHERINE LEPORE3 | KELLYDALE ST NW MASSILLON, OH 44646 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.02% |
| MICHAEL S CEJKA3 | 613 CEDAR ST HICKMAN, NE 68372 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.02% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | HYATT LEGAL PLANS | $2K | $487 | $2K | 12.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $714K |
| AP BENEFIT ADVISORS, LLC EIN 30-0837157 BENEFIT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $240K |
| EXPRESS SCRIPTS, INC EIN 22-3461740 RX ADMIN | Claims processing Service code 12 | — | $55K |
| THE LINCOLN NATIONAL LIFE INS CO EIN 35-0472300 STD ADMIN | Claims processing Service code 12 | — | $52K |
| CIGNA HEATH AND LIFE INS COMPANY EIN 59-1031071 DENTAL ADMIN | Claims processing; Contract Administrator Service code 12 | — | $47K |
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 | 1,578 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 21 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,619 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 509 | $95K |
| Vision | VISION SERVICE PLAN | 944 | $141K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,578 | $109K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 616 | $166K |
| Other(9 contracts, 6 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,578 | $650K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,578 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.