No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD NEBRASKA NONE | Claims processing; Other services Service code 12 | PO BOX 3248 402-982-7000 OMAHA, NE 681800001 | $1.0M |
| SUN LIFE FINANCIAL NONE | Insurance services Service code 23 | ONE SUN LIFE EXEC PARK WELLESLEY HILLS, MA 02481 | $711K |
| NEBR BANKERS INSURANCE & SVCS CO NE BANKERS ASSN. SUBSID. | Contract Administrator Service code 13 | PO BOX 80008 402-474-1555 LINCOLN, NE 685010008 | $429K |
| WELLNESS PARTNERS LLC NONE | Other services Service code 49 | 106 W 3RD ST MCCOOK, NE 69001 | $101K |
| GALLAGHER BENEFIT SERVICES NONE | Consulting (general) Service code 16 | 10050 REGENCY CIR STE 300 OMAHA, NE 68114 | $49K |
| CLINE WILLIAMS LAW FIRM NONE | Legal Service code 29 | 233 S 13TH ST SUITE 1900 402-474-6900 LINCOLN, NE 68508 | $15K |
| STRAIN SLATTERY BARKLEY & CO., CPAS NONE | Accounting (including auditing) Service code 10 | 7130 S 29TH ST., SUITE F 402-420-7300 LINCOLN, NE 68516 | $8K |
| AGILX LLC NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 800 P ST, 300 LINCOLN, NE 68508 | $7K |
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 | 1,915 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,948 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.