| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT INSURANCE MARKETING, INC.3 Filed as: BENEFIT INSURANCE MARKETING INC | 1511 RED MILE ROAD LEXINGTON, KY 40504 | ANTHEM BLUE CROSS/BLUE SHIELD | $3K | — | $3K | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10050 REGENCY CIRCLE OMAHA, NE 68114 | COVENTRY HEALTH AND LIFE | — | $9K | $9K | 0.39% |
| WILLIAMS DERAS AND ASSOC Filed as: WILLIAMS DERAS & ASSOC | 302 S 36TH STREET, STE 105 OMAHA, NE 68131 | METROPOLITAN LIFE INSURANCE CO. | $3K | — | $3K | 6.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10050 REGENCY CIR STE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10050 REGENCY CIR, STE 300 OMAHA, NE 68114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR EIN 31-1558779 NONE | Contract Administrator Service code 13 | 333 WEST VINE STREET LEXINGTON, KY 40507 | $572K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Investment management; Custodial (securities) Service code 19 | 1900 E. 9TH STREET CLEVELAND, OH 44114 | $21K |
| FRANK N HESTAND CPA PSC EIN 61-1336870 NONE | Accounting (including auditing) Service code 10 | 261 REGENCY CIRCLE LEXINGTON, KY 40503 | $19K |
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 | 1,909 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,909 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS/BLUE SHIELD | 8,039,970 | $8.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF KENTUCKY | 1,642 | $309K |
| Vision | VISION SERICE PLAN | 59 | $9K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 371 | $3.1M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 371 | $3.1M |
| Long-term disability(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 371 | $3.1M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 140 | $512K |
| Other | METROPOLITAN LIFE INSURANCE CO. | 292 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,039,970 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.