| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | BLUE CROSS AND BLUE SHIELD OF KANSAS | $22K | $0 | $22K | 1.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 13.08% |
| 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 | $0 | $1K | $1K | 1.65% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 100 BLOOMINGTON, MN 55437 | 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 | $341 | $0 | $341 | 9.00% |
| USI INSURANCE SERVICES LLC4 | 245 NORTH WACO STREET, SUITE 412 WICHITA, KS 67202 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $121 | $0 | $121 | 3.19% |
| 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 | $118 | $0 | $118 | 3.11% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF KANSAS | 169 | $1.2M |
| Dental | DELTA DENTAL OF KANSAS, INC. | 98 | $61K |
| Vision | SURENCY LIFE AND HEALTH | 89 | $11K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $85K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $85K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $85K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF KANSAS | 169 | $1.2M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.