| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 13710 FNB PKWY STE 400 OMAHA, NE 68114 | UNITEDHEALTHCARE INSURANCE COMPANY | $75K | $700 | $75K | 4.98% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 76 BATTERSON PARK RD STE 3 FARMINGTON, CT 06032 | PRINCIPAL LIFE INSURANCE GROUP | $4K | — | $4K | 4.99% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC-IL | C/O BANK OF AMERICA 15939 COLLECTIONS CENTER DR CHICAGO, IL 60693 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 9.74% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $59 | $2K | 14.55% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $339 | $81 | $420 | 3.16% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $259 | $116 | $375 | 2.82% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $253 | $8 | $261 | 1.96% |
| JENNIFER L HAVLOVICK3 Filed as: JENNIFER L HAVLOVIK | 4920 PLEASANT ST WEST DES MOINES, IA 50266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $151 | $14 | $165 | 1.24% |
| JOSEPH P CALARCO3 Filed as: JOSEPH MICHAEL EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $12 | $23 | 0.17% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $7 | $18 | 0.14% |
| ELAINE MURPHY3 | 44600 MONTEREY AVE PALM DESERT, CA 92260 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.06% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.05% |
| BRYON A BROWDER3 | 75 NW 57TH PL DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| NEBRASKA METHODIST HEALTH SYSTEM5 | 8511 WEST DODGE ROAD OMAHA, NE 68114 | NEBRASKA METHODIST HEALTH SYSTEM D/B/A BESTCARE EAP | — | $4K | $4K | — |
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 | 250 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 255 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE GROUP | 354 | $75K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 379 | $1.5M |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 211 | $38K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 22 | $13K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 211 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 379 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.