| 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 | $35K | — | $35K | 2.00% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 13710 FNB PKWY STE 400 OMAHA, NE 681545298 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $73 | $12K | 5.81% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST STE 900 ATTN TELLLYE HEDRICK KANSAS CITY, MO 641121906 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.11% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $138 | $5K | 9.73% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $619 | $3K | 7.04% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $49 | $1K | 2.18% |
| KRISTI LYN HOVIE3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $758 | $159 | $917 | 1.89% |
| JERRY A EDGAR3 | 7021 S 38TH ST LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $830 | $64 | $894 | 1.85% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $452 | $386 | $838 | 1.73% |
| EDGHILL ENTERPRISES LLC3 | 1420 WEST Q ST LINCOLN, NE 68528 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $652 | $74 | $726 | 1.50% |
| MICHAEL DONLEY3 | 2241 PUEBLO COURT SIOUX CITY, IA 51104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $438 | — | $438 | 0.90% |
| MARY-JOYCE LICATA3 Filed as: MARY J YARNELL | 170 E HAMILTON LN BATTLE CREEK, MI 49015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $314 | $13 | $327 | 0.67% |
| R & B ENROLLMENT SERVICES INC3 | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $179 | $9 | $188 | 0.39% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DR IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | $1 | $157 | 0.32% |
| PAMELA SWANSON ALLEN3 | 7736 WESTGATE DR LENEXA, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | $6 | $113 | 0.23% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $24 | $73 | 0.15% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK STREET NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.14% |
| INFINIUM ENTERPRISES LLC3 Filed as: INFINIUM ENTERPRISES, LLC | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $1 | $50 | 0.10% |
| RITA A FOUBERT3 | 204 MALLARD POINTE DR NW BONDURANT, IA 50035 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.06% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $10 | $26 | 0.05% |
| SHEALY BENEFITS SERVICES INC3 | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $11 | $23 | 0.05% |
| BRIAN JULIAN HAIR3 | 11 FALBROOK COURT IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $8 | $20 | 0.04% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $6 | $19 | 0.04% |
| ADVANCED BENEFIT SYSTEM INC3 | 145 RIVER LANDING DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $9 | $17 | 0.04% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $3 | $16 | 0.03% |
| DWAYNE P MURPHY3 | C/O DWAYNE MURPHY PALM DESERT, CA 92253 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10050 REGENCY CIRCLE OMAHA, NE 68114 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| CYD M WYATT3 | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| MA STILES LLC3 | 12223 CUMING ST OMAHA, NE 68154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| JENNIFER L HAVLOVICK3 Filed as: JENNIFER L. HAVLOVICK | 4920 PLEASANT ST WDM, IA 50266 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| JOSEPH P CALARCO3 Filed as: JOSEPH MICHAEL EVANS | 4721 BROOKVIEW DRIVE WEST DES MOINES, IA 50265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| JERRI J GREGORY3 | 791 NW 43RD AVE DES MOINES, IA 50313 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $260 | $68 | $328 | 9.70% |
| DEAN W FORNOFF3 | 16041 BUFFALO ROAD SPRINGFIELD, NE 68059 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $259 | $10 | $269 | 7.95% |
| HOVIE AGENCY LLC3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $96 | $92 | $188 | 5.56% |
| EDGHILL ENTERPRISES LLC3 | 1420 WEST Q ST LINCOLN, NE 68528 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $127 | $14 | $141 | 4.17% |
| RICHARD G MCGOWAN3 | 1716 N 59TH STREET OMAHA, NE 68104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $94 | $5 | $99 | 2.93% |
| JERRY A EDGAR3 | 7021 S 38TH ST LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $7 | $99 | 2.93% |
| MARY-JOYCE LICATA3 Filed as: MARY J YARNELL | 170 E HAMILTON LN BATTLE CREEK, MI 49015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $24 | $1 | $25 | 0.74% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R & B ENROLLMENT SERVICES INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $1 | $20 | 0.59% |
| INFINIUM ENTERPRISES LLC3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.30% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $2 | $6 | 0.18% |
| PAMELA SWANSON ALLEN3 | 7736 WESTGATE DR LENEXA, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.15% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.06% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| VGM BENEFIT ENROLLMENTS LLC3 | 30310 HORSETHIEF DRIVE TEHACHAPI, CA 93561 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.03% |
| NEBRASKA METHODIST HEALTH SYSTEM5 | 8511 WEST DODGE ROAD OMAHA, NE 68114 | NEBRASKA METHODIST HEALTH SYSTEM D/B/A BESTCARE EAP | — | $6K | $6K | — |
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 | 354 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 395 | $1.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 810 | $208K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 810 | $208K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 810 | $259K |
| Short-term disability(2 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 48 | $52K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 810 | $208K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 810 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 810 | — |
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.