| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GAIL COE4 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $352 | — | $352 | 6.03% |
| KEVIN D INGWERSON4 Filed as: KEVIN D. INGWERSON | 9402 E. 43RD CIR N WICHITA, KS 67226 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $340 | — | $340 | 5.82% |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $603 | $5K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $2K | — | $2K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | DELTA DENTAL OF KANSAS, INC. | $128 | — | $128 | — |
| GAIL A COE3 | 4600 FRAMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $2K | $147 | $2K | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF GREATER KANSAS INC | PO BOX 206 WICHITA, KS 67201 | AFLAC | $1K | — | $1K | — |
| JUSTIN C CARSON3 | 7701 E. KELLOGG SUITE 680 WICHITA, KS 67207 | AFLAC | $665 | $57 | $722 | — |
| KATHY WIEDEMANN3 | 220 HIGH VIEW DR BOULDER, CO 80304 | AFLAC | $478 | $68 | $546 | — |
| BRAD J SCHUMACHER3 | 718 MAIN ST STE 205 HAYS, KS 67601 | AFLAC | $148 | $68 | $216 | — |
| JAMES COE3 | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $131 | $59 | $190 | — |
| KEVIN D INGWERSON3 | 9402 E 43RD CIR N WICHITA, KS 67226 | AFLAC | $121 | $34 | $155 | — |
| HOLLY A. TIMMERMEYER3 Filed as: HOLLY A TIMMERMEYER | 3259 N. WOODLAND ST WICHITA, KS 67204 | AFLAC | $132 | — | $132 | — |
| SAMUEL A MCFALL3 | 609 N BROADWAY ST STE 200 WICHITA, KS 67214 | AFLAC | $103 | — | $103 | — |
| WILLINGHAM INC3 | 1502 N METCALF LOUISBURG, KS 66053 | AFLAC | $55 | — | $55 | — |
| NATHAN HARRISON3 | 16024 MANCHESTER RD 2ND FLOOR STE 200 ELLISVILLE, MO 63011 | AFLAC | $29 | — | $29 | — |
| SCOTT D SWIMMER3 | 4553 WEST 138TH TERRACE LEAWOOD, KS 66224 | AFLAC | $28 | — | $28 | — |
| RODNEY G STORCK3 | 150 N MAIN STE 910 WICHITA, KS 67202 | AFLAC | $20 | — | $20 | — |
| BOBBY JONES3 Filed as: BOBBY DEAN JONES | 1831 E DONNER DR PHOENIX, AZ 85042 | AFLAC | $15 | — | $15 | — |
| BRIAN MILLS3 | 1116 REMINGTON PLZ STE A RAYMORE, MO 64083 | AFLAC | $14 | — | $14 | — |
| ARMOND W BECHARD JR3 | 14757 FAIRWAY ST OVERLAND PARK, KS 66224 | AFLAC | $13 | — | $13 | — |
| PAUL HOMAN3 Filed as: PAUL E HOMAN | 5300 N WICHITA AVE WICHITA, KS 67204 | AFLAC | $13 | — | $13 | — |
| KELSEY M KUHLMAN3 | 150 N MAIN ST STE 910 WICHITA, KS 67202 | AFLAC | $6 | — | $6 | — |
| ANDREW COE3 Filed as: ANDREW J COE | 4600 FARMSTEAD CT BEL AIRE, KS 67220 | AFLAC | $4 | — | $4 | — |
| GARY WAYNE WILLINGHAM3 | 8116 STATE ROAD 66 ZOLFO SPRINGS, FL 33890 | AFLAC | $4 | — | $4 | — |
| MARC LUTHER HOMAN3 | 11828 W CENTRAL AVE STE 100 WICHITA, KS 67212 | AFLAC | $3 | — | $3 | — |
| CALEB GILMOUR3 Filed as: CALEB J GILMOUR | 310 W CENTRAL AVE STE D ANDOVER, KS 67002 | AFLAC | $2 | — | $2 | — |
| LEO SUPAK3 Filed as: LEO D SUPAK | 11800 WILSHIRE AVE NE ALBUQUERQUE, NM 87122 | AFLAC | $1 | — | $1 | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $361 | $5K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $60 | $1K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI MIDWEST LLC | 245 N. WACO, SUITE 300 WICHITA, KS 67202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $375 | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY HEALTH CARE OF KANSAS INC EIN 48-0840330 | Direct payment from the plan; Claims processing; Insurance brokerage commissions and fees Service code 12 | 8301 EAST 21ST WICHITA, KS 67206 | $2K |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(3 contracts) | DELTA DENTAL OF KANSAS, INC. | 153 | $143 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 241 | $0 |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 241 | $0 |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 241 | $0 |
| Other(5 contracts, 4 carriers) | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 241 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.