| 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 | $44K | $2K | $46K | 2.55% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 3 EMBARCADERO CTR STE 609 SAN FRANCISCO, CA 941114065 | PRINCIPAL LIFE INSURANCE GROUP | $4K | — | $4K | 4.34% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | KS CITY SERVICES 1015 N 98TH ST STE 101 OMAHA, NE 681142357 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 9.43% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | KS CITY SERIES 1015 N 98TH ST STE 101 OMAHA, NE 681142357 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 10.32% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $77 | $2K | 8.74% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $403 | $2K | 5.95% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $560 | $124 | $684 | 2.48% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $461 | $163 | $624 | 2.26% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $451 | $43 | $494 | 1.79% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $75 | $163 | 0.59% |
| GRUND BENEFIT ADVISORS LLC3 | 14669 MEREDITH AVE OMAHA, NE 68116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $19 | $51 | 0.18% |
| JENNIFER L HAVLOVICK3 Filed as: JENNIFER L HAVLOVIK | 4920 PLEASANT ST WEST DES MOINES, IA 50266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | $1 | $48 | 0.17% |
| DWAYNE P MURPHY3 | 45190 SEELEY DR LA QUINTA, CA 92253 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.06% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.03% |
| JOSEPH MICHAEL EVANS3 | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| NEBRASKA METHODIST HEALTH SYSTEM5 | 8511 WEST DODGE ROAD OMAHA, NE 68114 | NEBRASKA METHODIST HEALTH SYSTEM D/B/A BESTCARE EAP | — | $5K | $5K | — |
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 | 293 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 414 | $1.8M |
| Dental | PRINCIPAL LIFE INSURANCE GROUP | 399 | $97K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 414 | $1.8M |
| Life insurance(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 263 | $89K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 27 | $28K |
| Other(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 263 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.