| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 7441 O STREET, SUITE 102 LINCOLN, NE 68510 | BLUE CROSS BLUE SHIELD OF NEBRASKA | $34K | $101 | $35K | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 7441 O STREET, SUITE 102 LINCOLN, NE 68510 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | $5K | $20K | 10.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12444 POWERCOURT DRIVE, SUITE 500 SAINT LOUIS, MO 63131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $182 | $3K | 31.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 7441 O STREET, SUITE 102 LINCOLN, NE 68510 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 17.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4201 WESTOWN PARKWAY, SUITE 120 WEST DES MOINES, IA 50266 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $112 | $0 | $112 | 1.18% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NEBRASKA | 136 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $187K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $187K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $187K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $187K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $187K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NEBRASKA | 136 | $1.1M |
| Other(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 183 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
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.