| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 Filed as: THE CHRISTENSEN GROUP, INC. | 9855 WEST 78TH STREET, SUITE 100 EDEN PRAIRIE, MN 55344 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $22K | $0 | $22K | 2.07% |
| CHRISTENSEN GROUP INC3 Filed as: THE CHRISTENSEN GROUP, INC. | 9855 WEST 78TH STREET, SUITE 100 EDEN PRAIRIE, MN 55344 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.10% |
| CHRISTENSEN GROUP INC3 Filed as: THE CHRISTENSEN GROUP, INC. | 9855 WEST 78TH STREET, SUITE 100 EDEN PRAIRIE, MN 55344 | DELTA DENTAL OF KANSAS, INC. | $3K | $0 | $3K | 5.00% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 100 BLOOMINGTON, MN 55437 | SURENCY LIFE AND HEALTH | $1K | $0 | $1K | 10.00% |
| B & C AGENCY INC4 Filed as: B & C AGENCY, INC. | 7867 SE 197TH TERRACE LATHAM, KS 67072 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $493 | $0 | $493 | 9.32% |
| CHRISTENSEN GROUP INC4 Filed as: THE CHRISTENSEN GROUP, INC. | 9855 WEST 78TH STREET, SUITE 100 EDEN PRAIRIE, MN 55344 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $196 | $0 | $196 | 3.71% |
| USI INSURANCE SERVICES LLC4 | 245 NORTH WACO STREET, SUITE 402 WICHITA, KS 67202 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $104 | $0 | $104 | 1.97% |
| AUSTIN HUGHES GAST3 | 24210 WEST HEDGECREEK CIRCLE ANDALE, KS 67001 | AFLAC | $146 | $0 | $146 | 2.84% |
| TANNER R KING3 Filed as: TANNER R. KING | 14820 EAST SIEFKES COURT WICHITA, KS 67230 | AFLAC | $74 | $7 | $81 | 1.58% |
| CALEB GILMOUR3 Filed as: CALEB J. GILMOUR | 515 SOUTH MAIN STREET, SUITE 105 WICHITA, KS 67202 | AFLAC | $70 | $7 | $77 | 1.50% |
| GREGORY L TYLER3 Filed as: GREGORY L. TYLER | 110 SOUTH VALLEY STREAM DRIVE DERBY, KS 67037 | AFLAC | $37 | $18 | $55 | 1.07% |
| ELIZABETH RIOS3 Filed as: ELIZABETH RIOS AND OTHER AGENTS | PO BOX 75101 WICHITA, KS 67275 | AFLAC | $7 | $12 | $19 | 0.37% |
| ENVIRON CONSULTING GROUP LLC3 Filed as: ENVIRON CONSULTING GROUP, LLC | 515 SOUTH MAIN STREET WICHITA, KS 67202 | AFLAC | $13 | $0 | $13 | 0.25% |
| BRIAN M LEITZEL3 Filed as: BRIAN M. LEITZEL | 4201 SPRING DRIVE CHENEY, KS 67025 | AFLAC | $8 | $0 | $8 | 0.16% |
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 157 | $1.1M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 90 | $63K |
| Vision(2 contracts, 2 carriers) | SURENCY LIFE AND HEALTH | 83 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $75K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $75K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 139 | $75K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 157 | $1.1M |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.