| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | BLUE CROSS BLUE SHIELD OF KANSAS | $30K | — | $30K | 21.89% |
| ROBERT E. MILLER INSURANCE AGENCY3 | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $70 | $8K | 10.53% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $686 | $5K | 6.09% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $858 | — | $858 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $858 | $858 | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $188 | $188 | 1.10% |
| DIANA LEWIS3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $894 | $86 | $980 | 6.86% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $720 | $70 | $790 | 5.53% |
| DESSO FORMAN3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $546 | — | $546 | 3.82% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $241 | $16 | $257 | 1.80% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $704 | — | $704 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $704 | $704 | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $143 | $143 | 1.02% |
| USI INSURANCE SERVICES LLC3 | 245 NORTH WACO, SUITE 412 WICHITA, KS 67202 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $520 | — | $520 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $520 | $520 | 5.00% |
| DIANA LEWIS3 | 28059 US HIGHWAY 19 N., SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $57 | $1K | 14.35% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $70 | $1K | 13.48% |
| DESSO FORMAN3 | 28059 US HIGHWAY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $972 | — | $972 | 11.63% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $351 | $16 | $367 | 4.39% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $388 | — | $388 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $388 | $388 | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $86 | $86 | 1.11% |
| ROBERT E. MILLER INSURANCE AGENCY3 Filed as: ROBERT E MILLER INSURANCE AGENCY | 6363 COLLEGE BOULEVARD, SUITE 400 LEAWOOD, KS 66211 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $122 | — | $122 | 9.24% |
| USI INSURANCE SERVICES LLC3 | 245 N. WACO, SUTIE 412 WICHITA, KS 67202 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $76 | — | $76 | 5.76% |
| GROUP INSURANCE SERVICES INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $66 | — | $66 | 5.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | 9401 AMBERGLEN BOULEVARD, SUITE 100 AUSTIN, TX 78729 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $66 | $66 | 5.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $15 | $15 | 1.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF KANSAS EIN 48-0952857 ADMINISTRATOR | Contract Administrator Service code 13 | — | $115K |
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 | 184 | 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) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 591 | $79K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 259 | $17K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 256 | $24K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 163 | $17K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF KANSAS | 184 | $139K |
| Other(5 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 256 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 591 | — |
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.