| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E 32ND ST NORTH SUITE 100 WICHITA, KS 67226 | BLUE CROSS BLUE SHIELD OF KANSAS | $66K | — | $66K | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E. 32ND ST NORTH STE 100 WICHITA, KS 67226 | DELTA DENTAL OF KANSAS, INC. | $7K | — | $7K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E 32ND ST NORTH STE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $10K | 15.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E 32ND ST NORTH SUITE 110 WICHITA, KS 67226 | SURENCY LIFE AND HEALTH | $5K | — | $5K | 11.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E 32ND ST NORTH STE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 12.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8110 E 32ND ST NORTH SUITE 100 WICHITA, KS 67226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $585 | $243 | $828 | 14.15% |
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 | 404 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF KANSAS | 842 | $2.2M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 371 | $218K |
| Vision | SURENCY LIFE AND HEALTH | 274 | $42K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 489 | $71K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 189 | $37K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS | 842 | $2.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 489 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 842 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.