Form 5500 · Employee benefit plan · SCOTTSBLUFF, NE
LEGACY COOPERATIVE
The filing calls this plan LEGACY COOPERATIVE LIFE INSURANCE WELFARE PLAN.
LEGACY COOPERATIVE of SCOTTSBLUFF, NE files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE NORTHWEST PTRS INS SVCS. Coverage is written through THE LINCOLN NATIONAL LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-0155610 · plan 502 · plan year 2025, filed Jun 11, 2026
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
All 2 insured contracts are life coverage with THE LINCOLN NATIONAL LIFE INSURANCE COMPANY.
The filing declares life and disability. Disability appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
Reported premium across the insured contracts is $112,383, with $7,572 in disclosed broker commissions — about 6.7% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
ACRISURE NORTHWEST PTRS INS SVCS is the broker of record on all 2 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 125 | Jan 1, 2026 | $27,602 | $4,140 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | Life | 233 | Jan 1, 2026 | $84,781 | $3,432 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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