| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VHA MID AMERICA INS SVCS3 Filed as: VHA MID-AMERICA INS. SERVICES, LLC | PO BOX 842167 DALLAS, TX 75284 | HARTFORD LIFE AND ACCIDENT | $82K | $0 | $82K | 8.61% |
| VIZIENT INSURANCE SERVICES LLC3 Filed as: VIZIENT INSURANCE SERVICES, LLC | PO BOX 842167 DALLAS, TX 75284 | HARTFORD LIFE AND ACCIDENT | $0 | $40K | $40K | 4.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 0.80% |
| TIM OLSON INC3 Filed as: TIM OLSON, INC. | 16820 FRANCES STREET, SUITE 202 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27K | $0 | $27K | 11.99% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19K | $0 | $19K | 8.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 7441 O STREET, SUITE 102 LINCOLN, NE 68514 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | 11516 MIRACLE HILLS DRIVE OMAHA, NE 68154 | METLIFE LEGAL PLANS | $3K | $477 | $3K | 10.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | METLIFE LEGAL PLANS | $479 | $0 | $479 | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | METLIFE LEGAL PLANS | — | $30 | $30 | 0.10% |
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 | 1,202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,286 | $956K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,286 | $956K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,286 | $956K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 1,365 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,365 | — |
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.