| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 1.75% |
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 7.11% |
| SENIOR MARKET SALES INC3 | 8420 W DODGE RD STE 510 OMAHA, NE 68114 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 1.92% |
| LORRIE KATELMAN3 | 1027 N 184TH ST ELKHORN, NE 68022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.39% |
| GARY KATELMAN3 | 1027 N 184 ST ELKHORN, NE 68022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.09% |
| LONG TERM CARE FINANCIAL PARTNERS3 | 5110 CLARILLON POINT KIRKLAND, WA 98033 | MUTUAL OF OMAHA | $7K | — | $7K | 9.52% |
| AMERICAN INDEPENDENT MARKETING3 | P.O. BOX 9366 YAKIMA, WA 98909 | MUTUAL OF OMAHA | $2K | — | $2K | 3.01% |
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 4.70% |
| J G ELLIOTT COMPANY3 Filed as: J.G. ELLIOTT CO | PO BOX 1648 SCOTTSBLUFF, NE 69363 | AFLAC | $962 | — | $962 | 2.85% |
| KEVIN C ARMSTRONG3 | 4027 WEST FAIDLEY AVE GRAND ISLAND, NE 68803 | AFLAC | $628 | — | $628 | 1.86% |
| B.C. ENTERPRISES, INC.3 Filed as: B.C. ENTERPRISES, INC | 5151 N 150TH STREET OMAHA, NE 68116 | AFLAC | $332 | — | $332 | 0.98% |
| WILLIAM W ARMSTRONG3 | PO BOX 448 OGALLALA, NE 69153 | AFLAC | $284 | — | $284 | 0.84% |
| MARK FRIEHE3 Filed as: MARK E FRIEHE | 4611 S 96TH ST STE 101 OMAHA, NE 68127 | AFLAC | $283 | — | $283 | 0.84% |
| WILLIAM W ARMSTRONG3 Filed as: WILLIAM K ARMSTRONG | 707 S 201ST AVE ELKHORN, NE 68022 | AFLAC | $221 | — | $221 | 0.66% |
| MARDEE LOUISE DOWNING BICE3 | 1713 1ST AVE SCOTTSBLUFF, NE 69361 | AFLAC | $168 | — | $168 | 0.50% |
| M P WILKEN INC3 | PO BOX 725 KEARNEY, NE 68848 | AFLAC | $131 | — | $131 | 0.39% |
| MICHELE K WILLEY3 | 1517 BROADWAY STE 110 SCOTTSBLUFF, NE 69361 | AFLAC | $99 | — | $99 | 0.29% |
| KURT HUDSON3 Filed as: KURT G HUDSON | 1415 COLORADO AVE ALLIANCE, NE 69301 | AFLAC | $80 | — | $80 | 0.24% |
| JTH INC3 | 2215 W A STREET NORTH PLATTE, NE 69101 | AFLAC | $50 | — | $50 | 0.15% |
| WILLINGHAM INC3 | 1502 N METCALF LOUISBURG, KS 66053 | AFLAC | $49 | — | $49 | 0.15% |
| STARLA QUEEN3 Filed as: STARLA J QUEEN | 1060 LAKEVIEW WEST RD BRULE, NE 69127 | AFLAC | $39 | — | $39 | 0.12% |
| THOMAS EDWARD SHEFFIELD3 | PO BOX 151 MCCOOL JUNCTION, NE 68401 | AFLAC | $38 | — | $38 | 0.11% |
| CRAVEN GORDON ENTERPRISES3 | PO BOX 533 BASSET, NE 68714 | AFLAC | $37 | — | $37 | 0.11% |
| GARY WAYNE WILLINGHAM3 | 8116 STATE ROAD 66 ZOLFO SPRINGS, FL 33890 | AFLAC | $32 | — | $32 | 0.09% |
| KEVIN B VINING3 Filed as: KEVIN B. VINING | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC | $32 | — | $32 | 0.09% |
| MICHAEL P WILKEN3 | PO BOX 725 KEARNEY, NE 68848 | AFLAC | $27 | — | $27 | 0.08% |
| FIRST INSURANCE GROUP LLC3 | PO BOX 910 ALLIANCE, NE 69301 | AFLAC | $24 | — | $24 | 0.07% |
| DEBORAH A BROOKS3 | 1620 E 4TH ST STE 114A NORTH PLATTE, NE 69101 | AFLAC | $24 | — | $24 | 0.07% |
| MIKE BROOMFIELD3 Filed as: MIKE W BROOMFIELD | O PRAIRIE HILLS ROAD MCCOOK, NE 69001 | AFLAC | $20 | — | $20 | 0.06% |
| GREG LITZ3 | 2005 GATEWAY DR GRAND FORKS, ND 58203 | AFLAC | $20 | — | $20 | 0.06% |
| RUBY BISHOP3 Filed as: RUBY D BISHOP | 3726 JUNIPER DR SCOTTSBLUFF, NE 69361 | AFLAC | $18 | — | $18 | 0.05% |
| MONTE HARNER3 Filed as: MONTE G HARNER | 1306 N MAIN ST FREMONT, NE 68025 | AFLAC | $18 | — | $18 | 0.05% |
| KAREN YADEN3 | 17051 MOORSIDE DR PARKER, CO 80134 | AFLAC | $17 | — | $17 | 0.05% |
| BRENT L GOODE3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $15 | — | $15 | 0.04% |
| DENNIS GRAHAM3 Filed as: DENNIS C GRAHAM | 10 DRIVER CLUB CODY, WY 82414 | AFLAC | $13 | — | $13 | 0.04% |
| FREDERICK R SCHREMP3 | 3625 CUMBERLAND BLVD SE STE 800 ATLANTA, GA 30339 | AFLAC | $13 | — | $13 | 0.04% |
| VALLEY INSURANCE SERVICES, INC.3 Filed as: VALLEY INSURANCE SERVICES INC | PO BOX 716 GERING, NE 69341 | AFLAC | $11 | — | $11 | 0.03% |
| ROBERT L OLMSTEAD3 | 18472 W VERDIN RD GOODYEAR, AZ 85338 | AFLAC | $11 | — | $11 | 0.03% |
| KATHRYN BAILEY3 | PO BOX 82 HYATTVILLE, WY 82428 | AFLAC | $6 | — | $6 | 0.02% |
| JAY QUEEN3 | 1260 LAKEVIEW WEST RD BRULE, NE 69127 | AFLAC | $6 | — | $6 | 0.02% |
| JAMES D STEPHENS3 | 26710 MANDRAKE FALLS CT KATY, TX 77494 | AFLAC | $5 | — | $5 | 0.01% |
| KENNETH KYLE REVELLE3 | PO BOX 1122 CLIFTON, CO 81520 | AFLAC | $5 | — | $5 | 0.01% |
| DANIEL L FRENCH3 | 240 43RD AVE GREELEY, CO 80634 | AFLAC | $5 | — | $5 | 0.01% |
| DEANNA M CHRISTENSEN3 | PO BOX 2175 ROCK SPRINGS, WY 82902 | AFLAC | $4 | — | $4 | 0.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | 3625 CUMBERLAND BLVD SE STE 800 ATLANTA, GA 30339 | AFLAC | $4 | — | $4 | 0.01% |
| LISA JENKINS3 Filed as: LISA J JENKINS | 768 RANGER DRIVE CHEYENNE, WY 82009 | AFLAC | $4 | — | $4 | 0.01% |
| CYNTHIA D WELKEN-PLACE3 | 14710 W DODGE RD STE 200 OMAHA, NE 68154 | AFLAC | $3 | — | $3 | 0.01% |
| LISA HALL3 | 8601 TURNPIKE DR STE 206 WESTMINSTER, CO 80031 | AFLAC | $2 | — | $2 | 0.01% |
| RICHARD M HASLEM3 | PO BOX 1265 MONTROSE, CO 81402 | AFLAC | $2 | — | $2 | 0.01% |
| ALEXANDER B WARD3 | 5194 FOREST VIEW CT SE MABLETON, GA 30126 | AFLAC | $2 | — | $2 | 0.01% |
| THOMAS D BAXTER3 | PO BOX 86 FAYETTEVILLE, GA 30214 | AFLAC | $2 | — | $2 | 0.01% |
| BEN JENKINS3 | 768 RANGER DRIVE CHEYENNE, WY 82009 | AFLAC | $2 | — | $2 | 0.01% |
| LARRY E HAAS3 | 2262 TANGLEWOOD RD GRAND JUNCTION, CO 81507 | AFLAC | $1 | — | $1 | 0.00% |
| JONATHAN SAMUEL KIRKLAND3 | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL A MAYER3 | PO BOX 5625 PASCO, WA 99302 | AFLAC | $1 | — | $1 | 0.00% |
| ACSIA PARTNERS LLC3 Filed as: ACSIA LONG TERM CARE INC | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | LIFESECURE INSURANCE COMPANY | $23K | — | $23K | 206.55% |
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 | 254 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 79 | $187K |
| Dental | STANDARD INSURANCE COMPANY | 211 | $195K |
| Vision | AFLAC | 49 | $34K |
| Life insurance | STANDARD INSURANCE COMPANY | 249 | $70K |
| Short-term disability | AFLAC | 49 | $34K |
| Other(2 contracts, 2 carriers) | AFLAC | 49 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.