Form 5500 · Employee benefit plan · LEXINGTON, NE
NEBRASKALAND TIRE, INC.
The filing calls this plan NEBRASKALAND KANSASLAND CAFETERIA PLAN.
NEBRASKALAND TIRE, INC. of LEXINGTON, NE spreads its employee benefits across 4 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is IMA INC. Coverage is written through ADVANCE INSURANCE COMPANY OF KANSAS and 3 other carriers. The plan's most recent policy period ended in March.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-0561185 · plan 502 · plan year 2026, filed Aug 31, 2026
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25 other employer plans in Nebraska have policy years ending in March. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
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
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: death benefits, 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.
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
Schedule A lists 4 insured contracts covering dental, vision, life and disability; the largest, with ADVANCE INSURANCE COMPANY OF KANSAS, covers 556 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $248,907, with $23,644 in disclosed broker commissions — about 9.5% of premium.
The most recent policy period ended in March, and the plan year ends March 31. Group contracts typically renew on that annual cycle.
IMA INC is the broker of record on 1 of the 4 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ADVANCE INSURANCE COMPANY OF KANSAS | Life, Disability | 556 | Apr 1, 2026 | $122,881 | $14,747 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 298 | Apr 1, 2026 | $26,091 | $3,908 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | — | Apr 1, 2026 | $20,778 | $2,876 |
| BLUE CROSS AND BLUE SHIELD OF KANSAS | Dental | 363 | Apr 1, 2026 | $79,157 | $2,113 |
Premium and claims on this contract
BLUE CROSS AND BLUE SHIELD OF KANSAS, contract 07935. For the contract year on this filing, the carrier reported $79,157 in premium earned and $76,809 in claims incurred. Dividing one by the other gives 97%.
- BLUE CROSS AND BLUE SHIELD OF KANSAS, contract 07935 reported $9,039 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 21 employees, 0 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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Renewal calendar
25 other employer plans in Nebraska are April 1 renewals (policy year ends March).
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