| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEBRASKA BANKERS INS & SRVCS3 Filed as: NEBRASKA BANKERS INS & SVCS | 233 S 13TH ST, STE 700 LINCOLN, NE 68508 | STANDARD INSURANCE COMPANY | $148K | — | $148K | 5.00% |
| DONALD L SOUTHWORTH3 | 9604 STATE LANE RD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $24K | — | $24K | 0.82% |
| NEBRASKA BANKERS INS & SRVCS3 | 233 S 13TH ST STE 700 LINCOLN, NE 68508 | STANDARD INSURANCE COMPANY | $115K | — | $115K | 10.08% |
| DONALD L SOUTHWORTH3 | 9604 STATE LANE RD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $21K | — | $21K | 1.89% |
| NEBRASKA BANKERS INS & SRVCS3 | 233 S 13TH ST STE 700 LINCOLN, NE 68508 | STANDARD INSURANCE COMPANY | $43K | — | $43K | 7.00% |
| DONALD L SOUTHWORTH3 | 9604 STATE LANE RD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 0.97% |
| NEBRASKA BANKERS INS & SRVCS3 | 233 S 13TH ST STE 700 LINCOLN, NE 68508 | STANDARD INSURANCE COMPANY | $55K | — | $55K | 10.00% |
| DONALD L SOUTHWORTH3 | 9604 STATE LANE RD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 2.17% |
| NEBRASKA BANKERS INS & SRVCS3 | 233 S 13TH ST STE 700 LINCOLN, NE 68508 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 7.50% |
| DONALD L SOUTHWORTH3 | 9604 STATE LANE RD LEAWOOD, KS 66206 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 2.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD NEBRASKA NONE | Other services; Contract Administrator Service code 13 | PO BOX 3248 402-982-7000 OMAHA, NE 681800001 | $1.5M |
| NEBR BANKERS INSURANCE & SVCS CO NE BANKERS ASSN SUBSIDIAR | Contract Administrator Service code 13 | PO BOX 80008 402-474-1555 LINCOLN, NE 685010008 | $650K |
| CLINE WILLIAMS LAW FIRM NONE | Legal Service code 29 | 233 S 13TH ST SUITE 1900 402-474-6900 LINCOLN, NE 68508 | $27K |
| STRAIN SLATTERY BARKLEY & CO., CPAS NONE | Accounting (including auditing) Service code 10 | 7130 S 29TH ST., SUITE F 402-420-7300 LINCOLN, NE 68516 | $10K |
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 | 2,692 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,724 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 3,678 | $3.0M |
| Vision | STANDARD INSURANCE COMPANY | 2,656 | $614K |
| Life insurance | STANDARD INSURANCE COMPANY | 5,571 | $1.1M |
| Short-term disability | STANDARD INSURANCE COMPANY | 680 | $120K |
| Long-term disability | STANDARD INSURANCE COMPANY | 3,772 | $545K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,571 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.