| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | COMPANION LIFE | $19K | — | $19K | 5.77% |
| GERALD G. HARTMAN3 Filed as: GERALD G HARTMAN | 1487 S DAVID LANE BOISE, ID 83705 | COMPANION LIFE | $10K | — | $10K | 2.88% |
| SENIOR MARKET SALES INC3 Filed as: SENIOR MARKET SALES INC. | 8420 W DODGE RD, SUITE 510 OMAHA, NE 68114 | PROVIDENT LIFE AND ACCIDENT | — | $3K | $3K | 2.79% |
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | PROVIDENT LIFE AND ACCIDENT | $2K | — | $2K | 1.71% |
| KATELMAN, LORRIE, FARRIS3 | 1027 N 184TH STREET ELKHORN, NE 68022 | PROVIDENT LIFE AND ACCIDENT | $316 | — | $316 | 0.34% |
| LONG TERM CARE FINANCIAL PARTNERS3 | 5110 CLARILLON POINT KIRKLAND, WA 98033 | MUTUAL OF OMAHA | $6K | — | $6K | 9.48% |
| AMERICAN INDEPENDENT MARKETING3 | P.O. BOX 9366 YAKIMA, WA 98909 | MUTUAL OF OMAHA | $2K | — | $2K | 3.00% |
| ANNETTE S WULFF3 | 471 E SCENIC DR GRAND JUNCTION, CO 81507 | AFLAC | $3K | $112 | $3K | 5.11% |
| NATHEN T GORTEMAKER3 | 7093 SUNDANCE LOOP CHEYENNE, WY 82009 | AFLAC | $892 | $327 | $1K | 2.20% |
| J G ELLIOTT COMPANY3 Filed as: J.G. ELLIOTT CO | PO BOX 1648 SCOTTSBLUFF, NE 69363 | AFLAC | $704 | — | $704 | 1.27% |
| KEVIN C ARMSTRONG3 | 4027 WEST FAIDLEY AVE GRAND ISLAND, NE 68803 | AFLAC | $592 | — | $592 | 1.07% |
| ASPEN R KEATING | 596 ANNA RD IGNACIO, CO 81137 | AFLAC | $409 | $22 | $431 | 0.78% |
| ADRIAN ERIC SALAZAR | 1048 INDEPENDENT AVE STE A207 GRAND JUNCTION, CO 81505 | AFLAC | $308 | — | $308 | 0.56% |
| B.C. ENTERPRISES, INC.3 | 5151 N 150TH STREET OMAHA, NE 68116 | AFLAC | $301 | — | $301 | 0.54% |
| ADRIAN ERIC SALAZAR | 109 TICKSEED AVE SAVOY, IL 61874 | AFLAC | $300 | — | $300 | 0.54% |
| DB INSURANCE INC3 Filed as: DB BENEFITS INC | 1620 E 4TH ST STE 114A NORTH PLATTE, NE 69101 | AFLAC | $230 | $59 | $289 | 0.52% |
| WILLIAM W ARMSTRONG3 | PO BOX 448 OGALLALA, NE 69153 | AFLAC | $276 | — | $276 | 0.50% |
| WILLIAM W ARMSTRONG3 Filed as: WILLIAM K ARMSTRONG | 707 S 201ST AVE ELKHORN, NE 68022 | AFLAC | $226 | — | $226 | 0.41% |
| MARK FRIEHE Filed as: MARK E FRIEHE | 11218 JOHN GALT BLVD STE 101 OMAHA, NE 68137 | AFLAC | $188 | — | $188 | 0.34% |
| MICHELE K WILLEY3 | 500 S FLORIDA AVE STE 400-12 LAKELAND, FL 33801 | AFLAC | $120 | — | $120 | 0.22% |
| MICHELE K WILLEY | 100 S KENTUCKY AVE STE 240 LAKELAND, FL 33801 | AFLAC | $120 | — | $120 | 0.22% |
| JAY QUEEN3 | 1260 LAKEVIEW WEST RD BRULE, NE 69127 | AFLAC | $108 | — | $108 | 0.19% |
| MICHAEL P WILKEN3 | PO BOX 141 STE 5 OXFORD, NE 68967 | AFLAC | $108 | — | $108 | 0.19% |
| MARDEE LOUISE DOWNING BICE3 | 1713 1ST AVE SCOTTSBLUFF, NE 69361 | AFLAC | $108 | — | $108 | 0.19% |
| MANNY AM LLC3 | 596 ANNA RD IGNACIO, CO 81137 | AFLAC | $63 | $22 | $85 | 0.15% |
| KURT HUDSON3 | 1415 COLORADO AVE ALLIANCE, NE 69301 | AFLAC | $75 | — | $75 | 0.14% |
| MANUAL A MADRID3 | 6282 DOUGLAS CT N CHAMPLIN, CO 55316 | AFLAC | $57 | — | $57 | 0.10% |
| MICHELLE A JOHNSON3 | 437 CR 83 SIDNEY, NE 69162 | AFLAC | $55 | — | $55 | 0.10% |
| FIRST INSURANCE GROUP LLC3 | PO BOX 910 ALLIANCE, NE 69301 | AFLAC | $54 | — | $54 | 0.10% |
| ASPEN R LLC3 | 752 MAIN AVE STE 201 DURANGO, CO 81301 | AFLAC | $49 | — | $49 | 0.09% |
| STARLA QUEEN3 | 1060 LAKEVIEW WEST RD BRULE, NE 69127 | AFLAC | $48 | — | $48 | 0.09% |
| PLUMMER INSURANCE INC3 | PO BOX 548 BRIDGEPORT, NE 69336 | AFLAC | $45 | — | $45 | 0.08% |
| KEVIN B VINING3 Filed as: KEVIN B. VINING | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC | $44 | — | $44 | 0.08% |
| TRAVIS L WILLEY3 | 13909 RIVER WILLOW PL TAMPA, FL 33637 | AFLAC | $39 | — | $39 | 0.07% |
| TRAVIS L WILLEY3 | 100 S KENTUCKY AVE STE 240 LAKELAND, FL 33801 | AFLAC | $39 | — | $39 | 0.07% |
| KS BENEFITS GROUP INC3 | 304 W 7TH ST GORDON, NE 69343 | AFLAC | $37 | — | $37 | 0.07% |
| KRINGS ENTERPRISES INC3 Filed as: S KRINGS ENTERPRISES INC | 1330 PRAIRIE RIDGE DR POLK CITY, IA 50226 | AFLAC | $28 | — | $28 | 0.05% |
| WILLINGHAM INC3 | 1502 N METCALF LOUISBURG, KS 66053 | AFLAC | $27 | — | $27 | 0.05% |
| GARY WILLINGHAM3 | 6033 STRAFFORD OAKS DR SEBRING, FL 33875 | AFLAC | $27 | — | $27 | 0.05% |
| JTH INC3 | 2215 W A STREET NORTH PLATTE, NE 69101 | AFLAC | $27 | — | $27 | 0.05% |
| GREG LITZ3 | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $27 | — | $27 | 0.05% |
| BEN JENKINS3 | 768 RANGER DR CHEYENNE, WY 82009 | AFLAC | $27 | — | $27 | 0.05% |
| LISA JENKINS3 Filed as: LISA J JENKINS | 768 RANGER DR CHEYENNE, WY 82009 | AFLAC | $26 | — | $26 | 0.05% |
| NANCY MAYER3 | PO BOX 5625 PASCO, WA 99302 | AFLAC | $26 | — | $26 | 0.05% |
| BRENT L GOODE3 | 2000 GLEN ECHO RD STE 204 NASHVILLE, TN 37215 | AFLAC | $25 | — | $25 | 0.05% |
| MONTE HARNER3 | 9150 LEIGHTON AVE LINCOLN, NE 68507 | AFLAC | $24 | — | $24 | 0.04% |
| THOMAS EDWARD SHEFFIELD3 Filed as: THOMAS SHEFFIELD | PO BOX 151 MCCOOL JUNCTION, NE 68401 | AFLAC | $23 | — | $23 | 0.04% |
| MICHAEL CEJKA3 | 5626 S 38TH ST LINCOLN, NE 68516 | AFLAC | $22 | — | $22 | 0.04% |
| KRINGS ENTERPRISES INC3 | 1330 PRAIRIE RIDGE DR POLK CITY, IA 50226 | AFLAC | $18 | — | $18 | 0.03% |
| MANUEL A MADRID | 1048 INDEPENDENT AVE STE A207 GRAND JUNCTION, CO 81505 | AFLAC | $10 | — | $10 | 0.02% |
| JAMES D STEPHENS3 Filed as: JAMES STEPHENS | 26710 MANDRAKE FALLS CT KATY, TX 77494 | AFLAC | $9 | — | $9 | 0.02% |
| JEFFREY HIMMELRICK3 | 2215 W A STREET NORTH PLATTE, NE 69101 | AFLAC | $9 | — | $9 | 0.02% |
| MICHAEL COPPESS3 | 108 N 49TH ST SUITE 207 OMAHA, NE 68132 | AFLAC | $8 | — | $8 | 0.01% |
| JOSEPH LEDOUX3 | 2411 CARTER AVE NASHVILLE, TN 37206 | AFLAC | $7 | — | $7 | 0.01% |
| MICHAEL A MAYER3 | PO BOX 5625 PASCO, WA 99302 | AFLAC | $7 | — | $7 | 0.01% |
| LISA M HALL3 | 2542 E SUNDOWN DR COEUR D ALENE, ID 83815 | AFLAC | $7 | — | $7 | 0.01% |
| MICHAEL A MAYER Filed as: MICHAEL MAYER | 4406 CAMPOLINA LN PASCO, WA 99301 | AFLAC | $7 | — | $7 | 0.01% |
| KENNETH R THOMASON3 Filed as: KENNETH THOMASON | 4610 N 134TH AVE OMAHA, NE 68164 | AFLAC | $4 | — | $4 | 0.01% |
| KIMBERLY DIAN CROCKETT3 Filed as: KIMBERLY CROCKETT | 1563 ASHLEY CREEK LN CORDOVA, TN 38016 | AFLAC | $3 | — | $3 | 0.01% |
| DANIEL J MCMECHAN3 Filed as: DANIEL MCMECHAN | 2244 COUNTRY CLUB RD GRENADA, MS 38901 | AFLAC | $3 | — | $3 | 0.01% |
| JANICE ROBINSON3 | 22010 BRIDGESTONE HAWK CT SPRING, TX 77388 | AFLAC | $3 | — | $3 | 0.01% |
| KIMBERLY DIAN CROCKETT | 505 LEE ROAD 214 PHENIX CITY, AL 36870 | AFLAC | $3 | — | $3 | 0.01% |
| JULIE CEJKA3 | 28301 POST ROCK CIR FIRTH, NE 68358 | AFLAC | $2 | — | $2 | 0.00% |
| FRANCES OSTERMEIER3 | 215 COLETON DR COPPERAS COVE, TX 76522 | AFLAC | $1 | — | $1 | 0.00% |
| CRAIG MICHELSEN3 | 1228 25TH AVE SW GREATS FALLS, MT 59404 | AFLAC | $1 | — | $1 | 0.00% |
| JAMES A PORTER3 | 223 STILLWATER CREEK DR BOZEMAN, MT 59718 | AFLAC | $1 | — | $1 | 0.00% |
| SENIOR COMMISSION FUNDING LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | LIFESECURE INSURANCE COMPANY | $3K | — | $3K | 13.00% |
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 | 306 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT | 91 | $214K |
| Dental | COMPANION LIFE | 292 | $335K |
| Vision | AFLAC | 91 | $55K |
| Life insurance | COMPANION LIFE | 292 | $335K |
| Short-term disability | AFLAC | 91 | $55K |
| Other(3 contracts, 3 carriers) | COMPANION LIFE | 292 | $413K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.