| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IL 60008 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $54K | $3 | $54K | 1.94% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INSURANCE | SERVICES INC PO BOX 28 DUBUQUE, IA 520040028 | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | $11K | — | $11K | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLD RD STE 1000 ROLLING MDWS, IL 600084036 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 4.99% |
| STRONG FINANCIAL RESOURCES INC3 Filed as: STRONG ADVISORY GROUP INC | 1611 10TH ST AURORA, NE 688181234 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 4.44% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INS SERVICE | PO BOX 28 DUBUQUE, IA 520040028 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1611 10TH ST STE A AURORA, NE 688181234 | VISION SERVICE PLAN | $3K | — | $3K | 9.27% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC | PO BOX 28 DUBUQUE, IA 520040028 | VISION SERVICE PLAN | $297 | — | $297 | 0.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1611 10TH STREET AURORA, NE 68818 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 55.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $345 | $345 | 3.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1611 10TH STREET AURORA, NE 68818 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 65.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $273 | $273 | 3.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1611 10TH STREET AURORA, NE 68818 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 50.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $261 | $261 | 3.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1611 10TH ST AURORA, NE 68818 | UNITEDHEATHCARE INSURANCE COMPANY | $358 | — | $358 | 4.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER | 10050 REGENCY CIRCLE OMAHA, NE 68114 | ZURICH AMERICAN INSURANCE COMPANY | $790 | — | $790 | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER | 10050 REGENCY CIRCLE OMAHA, NE 68114 | ZURICH AMERICAN INSURANCE COMPANY | $782 | — | $782 | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: AJ GALLAGHER BENEFITS SE | STE 1000 2850 GOLF RD ROLLINGTON MDWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $278 | — | $278 | 12.65% |
| COTTINGHAM & BUTLER4 Filed as: COTTINGHAM & BUTLER INS SERVICES | 800 MAIN ST DUBUQUE, IA 52001 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $94 | — | $94 | 4.28% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF NEBRASKA | 368 | $2.8M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $223K |
| Vision | VISION SERVICE PLAN | 163 | $36K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $223K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $223K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $223K |
| Other(8 contracts, 5 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 463 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 463 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.