| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | COMPANION LIFE | $21K | — | $21K | 3.41% |
| GERALD G. HARTMAN3 Filed as: GERALD G HARTMAN | 1487 S DAVID LANE BOISE, ID 83705 | COMPANION LIFE | $11K | — | $11K | 1.71% |
| SENIOR MARKET SALES INC3 Filed as: SENIOR MARKET SALES INC. | 8420 W DODGE RD, SUITE 510 OMAHA, NE 68114 | PROVIDENT LIFE AND ACCIDENT | — | $2K | $2K | 2.92% |
| J G ELLIOTT COMPANY3 | PO BOX 1648 SCOTTSBLUFF, NE 69363 | PROVIDENT LIFE AND ACCIDENT | $1K | — | $1K | 1.59% |
| KATELMAN, LORRIE, FARRIS3 | 1027 N 184TH STREET ELKHORN, NE 68022 | PROVIDENT LIFE AND ACCIDENT | $297 | — | $297 | 0.35% |
| LONG TERM CARE FINANCIAL PARTNERS3 | 5110 CLARILLON POINT KIRKLAND, WA 98033 | MUTUAL OF OMAHA | $6K | — | $6K | 9.61% |
| AMERICAN INDEPENDENT MARKETING3 | P.O. BOX 9366 YAKIMA, WA 98909 | MUTUAL OF OMAHA | $2K | — | $2K | 3.00% |
| SENIOR COMMISSION FUNDING LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | LIFESECURE INSURANCE COMPANY | $2K | — | $2K | 11.51% |
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 | 338 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT | 58 | $151K |
| Dental | COMPANION LIFE | 321 | $622K |
| Life insurance | COMPANION LIFE | 321 | $622K |
| Other(2 contracts, 2 carriers) | COMPANION LIFE | 321 | $638K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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.