| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHAWN J KEELER4 | 2209 1ST AVE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE CO | $28K | — | $28K | 14.77% |
| HOLMES MURPHY & ASSOCIATES4 Filed as: HOLMES MURPHY AND ASSOCIATES | PO BOX 441 DES MOINES, IA 50302 | AMERICAN HERITAGE LIFE INSURANCE CO | $11K | — | $11K | 5.59% |
| GROUP MARKETING SERVICES INC4 Filed as: GROUP MARKETING SERVICES INC. | 17445 ARBOR STREET STE 200 OMAHA, NE 68130 | AMERICAN HERITAGE LIFE INSURANCE CO | $2K | — | $2K | 1.20% |
| KEELER & ASSOCIATES4 | 2209 1ST AVE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE CO | $2K | — | $2K | 0.89% |
| ANTHONY C BUECHLER4 | 1203 COLONIAL CIRCLE OMAHA, NE 68046 | AMERICAN HERITAGE LIFE INSURANCE CO | $229 | — | $229 | 0.12% |
| HOLMES MURPHY & ASSOCIATES4 Filed as: HOLMES, MURPHY AND ASSOCIATES LLC | PO BOX 441 DES MOINES, IA 50302 | VISION SERVICE PLAN | $3K | — | $3K | 2.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 NONE | Claims processing Service code 12 | — | $67K |
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 | 683 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 683 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 1,551 | $592K |
| Dental | HCC LIFE INSURANCE COMPANY | 1,551 | $401K |
| Vision | VISION SERVICE PLAN | 724 | $101K |
| Long-term disability | MUTUAL OF OMAHA | 26 | $53K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | TOKIO MARINE | 1,551 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,551 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.